Active NPI
John Nguyen, OD
- Optometrist
- Fullerton, CA
National Provider Identifier
1750446001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11716T
- Practice address
- 1912 W Commonwealth Ave Ste D
Fullerton, CA 92833-3040 - Phone
- (714) 526-1513
- Fax
- (714) 526-1362
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11716T | CA | Primary |
Addresses
Primary practice location
1912 W Commonwealth Ave Ste D
Fullerton, CA 92833-3040
Mailing address
6259 Eisenhower CT
Chino, CA 91710-3757
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11716T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750446001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6259 EISENHOWER CT",
"city": "CHINO",
"state": "CA",
"postal_code": "917103757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1912 W COMMONWEALTH AVE STE D",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928333040",
"telephone_number": "714-526-1513",
"fax_number": "714-526-1362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11716T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.