Organization Active NPI

Dr. Mylinh Lam O.D, Inc

  • Optometrist
  • El Monte, CA
National Provider Identifier
1912196692
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10766T Issued in CA
Legal business name
DR. MYLINH LAM O.D, INC
Practice address
10921 Valley Mall
El Monte, CA 91731-2615
Phone
(626) 444-0369
Fax
(626) 444-1957
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Dr. Mylinh Lam, O.DNPI 1528102274
Title
Owner
Phone
(626) 444-0369

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 10766T CA Primary

Addresses

Primary practice location

10921 Valley Mall
El Monte, CA 91731-2615

Mailing address

10921 Valley Mall
El Monte, CA 91731-2615
Phone (626) 444-0369

Other identifiers 1

IdentifierTypeStateIssuer
SD0107660MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040520000222 CA Part B Supplier - Clinic/Group Practice 2668463597 Receives reassigned benefits from 1 practitioner
Practice locations: El Monte, CA

National Provider Directory

National Provider Directory

Locations

10917 Main St
El Monte, CA 91731
Phone (626) 444-0369

Practitioners & affiliated clinicians

Practitioners 1

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": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1912196692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 VALLEY MALL",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312615",
            "telephone_number": "626-444-0369",
            "fax_number": "626-444-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 VALLEY MALL",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312615",
            "telephone_number": "626-444-0369",
            "fax_number": "626-444-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MYLINH LAM O.D, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "MYLINH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-444-0369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10766T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0107660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.