Purevision Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

15268 Issued in CA

Legal business name

PUREVISION OPTOMETRY

Practice address

14420 Bear Valley Rd
Victorville, CA 92392-5404

Phone

(760) 243-2055

NPI assigned

Aug 12, 2015

Organization subpart

No

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

Authorized official

Name

Kelsey NguyenNPI 1205202215

Title

Optometrist

Phone

(760) 243-2055

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kelsey Nguyen, O.D.

  • Optometrist
  • Victorville, CA
  • NPI 1205202215
  NPD (past) Authorized official

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1760858872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14420 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923925404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14420 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923925404",
            "telephone_number": "760-243-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUREVISION OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "760-243-2055"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIST LICENSE",
            "identifier": "15268 TLG",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari Lynn Provost, P.A.
• Maxine Pryor
• Public in-Home Support Services Authority
• Kimberly Pukal
• Sheree Pulliam, MFT
• Puri Orthopedic Center, Inc.
• Geetha Puri, M.D.
• Cullan Forrest Putney
• Yin Xia Qian, P.A.
• Ivy Thoai Quach, PHARMD.

• Optometrist in Victorville, CA
• Providers in Victorville, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.