Dinuba Optometric Center Inc a Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DINUBA OPTOMETRIC CENTER INC A PROFESSIONAL CORPORATION

Practice address

119 S L St
Dinuba, CA 93618-2324

Phone

(559) 591-4656

Fax

(559) 591-4090

NPI assigned

Nov 10, 2020

Organization subpart

No

Name

Moses Thai, ODNPI 1225653322

Title

Sole Owner / President

Phone

(909) 694-9446

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Moses Thai, OD

  • Optometrist
  • Dinuba, CA
  • NPI 1225653322

  CA, Optometrist

  Medicare reassignment NPD Authorized official
• Allyson Farrell, OD

  • Optometrist
  • Dinuba, CA
  • NPI 1992880116
  NPD
• Robert B Farrell, OD

  • Optometrist
  • Dinuba, CA
  • NPI 1205911427
  NPD
• Wendy Lam, O.D.

  • Optometrist
  • Dinuba, CA
  • NPI 1992010490
  NPD

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 18, 2021.

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1609478189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4384 E ASHLAN AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937262600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S L ST",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936182324",
            "telephone_number": "559-591-4656",
            "fax_number": "559-591-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DINUBA OPTOMETRIC CENTER INC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "THAI",
        "authorized_official_first_name": "MOSES",
        "authorized_official_title_or_position": "SOLE OWNER / PRESIDENT",
        "authorized_official_telephone_number": "909-694-9446",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward John Derderian, PHARM.D.; R.PH.
• Mercedeh Deyhim, MS, PA-C
• Gabriel Diaz
• Dinuba Medical Center
• Dinuba Medical Clinic
• Dinuba Pharmacy Inc
• Dinuba Pharmacy Inc
• Dinuba Pharmacy Inc
• Dinuba Physical Therapy
• Dinuba Physical Therapy,Inc,

• All providers in Dinuba, CA
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.