Individual provider Active NPI

Quyen N. La, O.D.

  • Optometrist
  • Huntington Beach, CA
National Provider Identifier
1750466777
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12318T Issued in CA
Practice address
7251 Warner Ave Ste H
Huntington Beach, CA 92647-5487
Phone
(714) 596-2258
Fax
(714) 596-2248
NPI assigned
Oct 26, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12318T CA Primary

Addresses

Primary practice location

7251 Warner Ave Ste H
Huntington Beach, CA 92647-5487

Mailing address

7251 Warner Ave Ste H
Huntington Beach, CA 92647-5487
Phone (714) 596-2258

Other identifiers 1

IdentifierTypeStateIssuer
SD0123180MedicaidCA

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
I20040609001252 CA Practitioner - Optometry 9739162975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7251 Warner Ave
Suite H
Huntington Beach, CA 92647-5487
Phone (714) 596-2258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12318CAMDDental Hygienist
12318TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cerritos 2020 Optometry a Proffesional Optometric Corporatio Optometrist PastSince Mar 29, 2010 Accepting new patients

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, 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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1750466777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7251 WARNER AVE STE H",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475487",
            "telephone_number": "714-596-2258",
            "fax_number": "714-596-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7251 WARNER AVE STE H",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475487",
            "telephone_number": "714-596-2258",
            "fax_number": "714-596-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA",
        "first_name": "QUYEN",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12318T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0123180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.