Individual provider Active NPI

Diem Ngoc Tran, O.D.

  • Optometrist
  • Brea, CA
National Provider Identifier
1629065792
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12660T Issued in CA
Practice address
605 E Imperial Hwy
Suite C
Brea, CA 92821-5627
Phone
(714) 460-3489
Fax
(714) 257-1662
NPI assigned
Oct 4, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12660T CA Primary

Addresses

Primary practice location

605 E Imperial Hwy
Suite C
Brea, CA 92821-5627

Mailing address

17588 Ivy Place
Fountain Valley, CA 92708-7723
Phone (714) 460-3489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150312001997 CA Practitioner - Optometry 8224354022 Reassigns benefits to 1 organization
Practice locations: Brea, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12660CAMDAddiction (Substance Use Disorder) Counselor
12660TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye View Optometry, Inc Optometrist CurrentSince Sep 18, 2018 Accepting new patients
M Alexander Bonakdar OD Inc Optometrist Past Accepting new patients

Locations

605 E Imperial Hwy
Ste C
Brea, CA 92821
Phone (714) 257-1660

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1629065792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17588 IVY PLACE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087723",
            "telephone_number": "714-460-3489",
            "fax_number": "714-257-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E IMPERIAL HWY",
            "address_2": "SUITE C",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215627",
            "telephone_number": "714-460-3489",
            "fax_number": "714-257-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "DIEM",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12660T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.