Individual provider Active NPI

Diemkhanh Mary Dinhluu, O.D.

  • Optometrist
  • Santa Ana, CA
National Provider Identifier
1851496095
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT100277PA Issued in CA
Practice address
2414 S Fairview St Ste 103
Santa Ana, CA 92704-5318
Phone
(714) 557-9492
Fax
(714) 557-2548
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT100277PA CA Primary

Addresses

Primary practice location

2414 S Fairview St Ste 103
Santa Ana, CA 92704-5318

Mailing address

2111 Vallejo Dr
Tustin, CA 92782-8618
Phone (714) 422-9921

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20060302000592 CA Practitioner - Optometry 8224044086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10027CAMDAddiction (Substance Use Disorder) Counselor
OPT100277PACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 12, 2011 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 12, 2011 Accepting new patients
Hilton Manor, LLC Past Accepting new patients
Paje Optometric a Professional Corporation Optometrist PastSince Jul 30, 2014 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 5

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1851496095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 VALLEJO DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927828618",
            "telephone_number": "714-422-9921",
            "fax_number": "714-505-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 S FAIRVIEW ST STE 103",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045318",
            "telephone_number": "714-557-9492",
            "fax_number": "714-557-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINHLUU",
        "first_name": "DIEMKHANH",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT100277PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.