Individual provider Active NPI

Khanh V. Le, O.D.

  • Optometrist
  • Pomona, CA
National Provider Identifier
1760526842
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9595T Issued in CA
Practice address
1900 Royalty Dr Ste 100
Pomona, CA 91767-3048
Phone
(909) 469-4804
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9595T CA Primary

Addresses

Primary practice location

1900 Royalty Dr Ste 100
Pomona, CA 91767-3048

Mailing address

1900 Royalty Dr Ste 100
Pomona, CA 91767-3048
Phone (909) 469-4804

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
I20050512000401 CA Practitioner - Optometry 5193763761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pomona Valley Optometry IncGroup PAC ID 7012955685, 2 clinicians

Practice addresses (Care Compare)

1900 Royalty Dr
Suite 100
Pomona, CA 91767-3048
Phone (909) 469-4804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9595TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pomona Valley Optometry Inc Optometrist CurrentSince Dec 20, 2004 Accepting new patients

Locations

1900 Royalty Dr
Ste 100
Pomona, CA 91767
Phone (909) 469-4804

Organizations & group practices 1

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1760526842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 ROYALTY DR STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673048",
            "telephone_number": "909-469-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ROYALTY DR STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673048",
            "telephone_number": "909-469-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "KHANH",
        "middle_name": "V.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9595T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.