Tony D Pham OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

12348 Issued in CA

Legal business name

TONY D PHAM OD INC

Doing business as

Mira Mesa Eyecare

Practice address

6755 Mira Mesa Blvd.
Suite 141
San Diego, CA 92121-4311

Phone

(916) 483-6661

Fax

(916) 483-6664

NPI assigned

Jul 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tony Dieu Pham, O.D.NPI 1841271434

Title

President/Ceo

Phone

(858) 535-8282

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MIRA MESA EYECARE Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

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

• Tony Dieu Pham, O.D.

  • Optometrist
  • San Diego, CA
  • NPI 1841271434
  Medicare reassignment NPD Authorized official
• Danya Deiranieh, OD

  • Optometrist
  • San Diego, CA
  • NPI 1336951607
  NPD
• Valerie Tran, OD

  • Optometrist
  • San Diego, CA
  • NPI 1174009948
  NPD
• Vineeta Ahluwalia, O.D.

  • Optometrist
  • San Diego, CA
  • NPI 1770862393
  NPD (past)
• Jamie Lee Bergmark, OD

  • Optometrist
  • San Diego, CA
  • NPI 1669920757
  NPD (past)
• Richard Kenneth Simonds, O.D.

  • Optometrist
  • Hemet, CA
  • NPI 1710988027
  NPD (past)

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1760672315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6755 MIRA MESA BLVD",
            "address_2": "SUITE 141",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214392",
            "telephone_number": "858-535-8282",
            "fax_number": "858-535-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6755 MIRA MESA BLVD.",
            "address_2": "SUITE 141",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214311",
            "telephone_number": "916-483-6661",
            "fax_number": "916-483-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONY D PHAM OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "DIEU",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "858-535-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760672315",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIRA MESA EYECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tono Medical Services PC
• Chelsea Leigh Tonti, M.ED.
• Derrick Tonto
• Allison Tontz
• Tusialei Tonumailau
• Tony Tan Nguyen MD Inc
• Tyler Tony
• Conor Toohey, ND
• Dylan Christopher Tookey, MD
• Erin Tooley

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.