Kieutien Phan Tonnu, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10429T Issued in CA

Practice address

1101 E Holt Ave
Suite D
Pomona, CA 91767-5800

Phone

(909) 620-4546

Fax

(909) 620-4546

NPI assigned

Jun 30, 2008

Last updated

Sep 15, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• KT Tonnu an Optometric Corporation

  • Optometrist
  • Pomona, CA
  • NPI 1295831485
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1639331614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E HOLT AVE",
            "address_2": "SUITE D",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675800",
            "telephone_number": "909-620-4546",
            "fax_number": "909-620-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E HOLT AVE",
            "address_2": "SUITE D",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675800",
            "telephone_number": "909-620-4546",
            "fax_number": "909-620-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONNU",
        "first_name": "KIEUTIEN",
        "middle_name": "PHAN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10429T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE #",
            "identifier": "WY158",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0104290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jocelyn M Tomista, PA
• Caitlin Tong
• Cindy Tong
• Steven Tong
• Van My Tong
• Astrid Topete, M.S.
• Mayra Topete
• Abigail Torcedo
• Kayla Toro
• Yvette Torres-Saucedo, SPEECH PATHOLOGIST

• Optometrist in Pomona, CA
• Providers in Pomona, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.