Individual provider Active NPI

Tram Mai Nguyen, O.D.

  • Optometrist
  • Chula Vista, CA
National Provider Identifier
1902194715
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14174TLG Issued in CA
Practice address
557 H St
#B
Chula Vista, CA 91910-4330
Phone
(619) 422-0139
NPI assigned
Jul 13, 2011
Last updated
Jul 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14174TLG CA Primary

Addresses

Primary practice location

557 H St
#B
Chula Vista, CA 91910-4330

Mailing address

557 H St
#B
Chula Vista, CA 91910-4330

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
I20140325000053 CA Practitioner - Optometry 9830320522 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14174TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Peter D Huang, O.D. a Professional Corporation CurrentSince Dec 25, 2013 Accepting new patients

Locations

557 H St
#B
Chula Vista, CA 91910
Phone (619) 422-0139

557 H St
Ste B
Chula Vista, CA 91910
Phone (619) 422-0139

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1902194715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 H ST",
            "address_2": "#B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 H ST",
            "address_2": "#B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104330",
            "telephone_number": "619-422-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRAM",
        "middle_name": "MAI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14174TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.