Individual provider Active NPI

Katherine Le Nguyen, O.D.

  • Optometrist
  • Redondo Beach, CA
National Provider Identifier
1821549775
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33591 Issued in CA
Practice address
1815 Hawthorne Blvd Ste 236
Redondo Beach, CA 90278-3437
Phone
(310) 370-1618
NPI assigned
Oct 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33591 CA Primary

Addresses

Primary practice location

1815 Hawthorne Blvd Ste 236
Redondo Beach, CA 90278-3437

Mailing address

1815 Hawthorne Blvd Ste 236
Redondo Beach, CA 90278-3437

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
I20171201001298 CA Practitioner - Optometry 1355608274 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33591CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Aug 23, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 23, 2025 Accepting new patients
Global Laser Vision Medical Center Optometrist Past Accepting new patients

Locations

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

Organizations & group practices 3

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": "1476576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1821549775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 HAWTHORNE BLVD STE 236",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 HAWTHORNE BLVD STE 236",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783437",
            "telephone_number": "310-370-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KATHERINE",
        "middle_name": "LE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-16",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.