Jimmy Tung Le Nguyen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12845T Issued in CA

Practice address

2183 Vista Way
Ste B6
Oceanside, CA 92054-5680

Phone

(714) 210-3405

Fax

(714) 839-7424

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Eye Doctor Optometry

  • Optometrist
  • San Clemente, CA
  • NPI 1912220450
  NPD (past) Authorized official
• Clearoptix Optometric Group

  • Optometrist
  • Westminster, CA
  • NPI 1275849887
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1821124397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2183 VISTA WAY",
            "address_2": "STE B6",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545680",
            "telephone_number": "714-210-3405",
            "fax_number": "714-839-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2183 VISTA WAY",
            "address_2": "STE B6",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545680",
            "telephone_number": "714-210-3405",
            "fax_number": "714-839-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JIMMY",
        "middle_name": "TUNG LE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12845T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antony Ngondara, PHARMD
• Aimee Nguyen, DMD
• Alex Hoang Nguyen
• Alexander Dzuyan Nguyen, DDS
• Jessie Nguyen, PT, DPT
• Nga Francyne Nguyen, LCSW
• Tho Thi Nguyen, DPM
• Tiffany Nguyen
• Tuan D. Nguyen, M.D.
• Uyen Tran Phuong Nguyen, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.