Individual provider Active NPI

Linda Q Phan, OD

  • Optometrist
  • Milpitas, CA
National Provider Identifier
1619093812
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11756T Issued in CA
Practice address
208 Great Mall Dr
Milpitas, CA 95035-8040
Phone
(408) 263-3000
Fax
(408) 263-8277
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11756T CA Primary

Addresses

Primary practice location

208 Great Mall Dr
Milpitas, CA 95035-8040

Mailing address

208 Great Mall Dr
Milpitas, CA 95035-8040
Phone (408) 263-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11756TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Insight Optometry, Inc Optometrist CurrentSince Aug 27, 2023 Accepting new patients

Locations

208 Great Mall Dr
Milpitas, CA 95035
Phone (408) 263-3000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1619093812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 GREAT MALL DR",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950358040",
            "telephone_number": "408-263-3000",
            "fax_number": "408-263-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 GREAT MALL DR",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950358040",
            "telephone_number": "408-263-3000",
            "fax_number": "408-263-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "LINDA",
        "middle_name": "Q",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11756T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milpitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.