Organization Active NPI

Kim O Nguyen O D Inc

  • Optometrist
  • Laguna Hills, CA
National Provider Identifier
1861769135
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT11972 Issued in CA
Legal business name
KIM O NGUYEN O D INC
Doing business as
Alicia Valencia Eyecare Center of Optometry
Practice address
25401 Alicia Pkwy
Suite E
Laguna Hills, CA 92653-4958
Phone
(949) 951-8001
Fax
(959) 951-1552
NPI assigned
Nov 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Authorized official

Name
Dr. Kim Oanh Nguyen, O.D.NPI 1760534267
Title
President
Phone
(949) 951-8001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT11972 CA Primary

Addresses

Primary practice location

25401 Alicia Pkwy
Suite E
Laguna Hills, CA 92653-4958

Mailing address

25401 Alicia Pkwy Ste E
Laguna Hills, CA 92653-4958
Phone (949) 951-8001

Other identifiers 1

IdentifierTypeStateIssuer
CB228572OtherCAMEDICARE PTAN

Other names 1

  • Alicia Valencia Eyecare Center of Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150325000915 CA Part B Supplier - Other 6103143458 Receives reassigned benefits from 1 practitioner
Practice locations: Laguna Hills, CA

National Provider Directory

National Provider Directory

Locations

25401 Alicia Pkwy
Ste E
Laguna Hills, CA 92653
Phone (949) 697-8613

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1861769135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25401 ALICIA PKWY STE E",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534958",
            "telephone_number": "949-951-8001",
            "fax_number": "959-951-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25401 ALICIA PKWY",
            "address_2": "SUITE E",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534958",
            "telephone_number": "949-951-8001",
            "fax_number": "959-951-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM O NGUYEN O D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "OANH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-951-8001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT11972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB228572",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alicia Valencia Eyecare Center of Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.