NPIMap

Organization Active NPI

Jonathan Duong O.D., Inc.

  • Vision Therapy Optometrist
  • Laguna Beach, CA
National Provider Identifier
1700823283
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
11127T Issued in CA
Legal business name
JONATHAN DUONG O.D., INC.
Practice address
303 Broadway St
Suite 105
Laguna Beach, CA 92651-1816
Phone
(949) 715-2499
Fax
(949) 715-2493
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Authorized official

Name
Dr. Jonathan Duong, O.D.
Title
President
Phone
(949) 715-2499

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WL0500X 11127T CA
Vision Therapy OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WV0400X 11127T CA Primary

Addresses

Primary practice location

303 Broadway St
Suite 105
Laguna Beach, CA 92651-1816

Mailing address

303 Broadway St
Suite 105
Laguna Beach, CA 92651-1816
Phone (949) 715-2499

Other identifiers 1

IdentifierTypeStateIssuer
SD0111270MedicaidCA

Other names 1

  • Laguna Coast Optometry Doing business as

National Provider Directory

National Provider Directory

Locations

303 Broadway St
Ste 105
Laguna Beach, CA 92651
Phone (949) 715-2499

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1700823283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 BROADWAY ST",
            "address_2": "SUITE 105",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511816",
            "telephone_number": "949-715-2499",
            "fax_number": "949-715-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BROADWAY ST",
            "address_2": "SUITE 105",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511816",
            "telephone_number": "949-715-2499",
            "fax_number": "949-715-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN DUONG O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "DUONG",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-715-2499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "11127T",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "11127T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0111270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laguna Coast Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laguna Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.