Individual provider Active NPI

Cathy Linh Nguyen, O.D.

  • Optometrist
  • Fontana, CA
National Provider Identifier
1912260878
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14390 Issued in CA
Practice address
8190 Mango Ave
Fontana, CA 92335-3610
Phone
(909) 350-2020
Fax
(909) 350-2341
NPI assigned
Jun 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14390 CA Primary

Addresses

Primary practice location

8190 Mango Ave
Fontana, CA 92335-3610

Mailing address

8190 Mango Ave
Fontana, CA 92335-3610
Phone (909) 350-2020

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
I20120808000157 CA Practitioner - Optometry 5890941835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cathy Nguyen OD a Professional Optometric CorporationGroup PAC ID 3274981188, 2 clinicians

Practice addresses (Care Compare)

8190 Mango Ave
Fontana, CA 92335-3610
Phone (909) 350-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cathy Nguyen, O.D., a Professional Optometric Corporation Optometrist CurrentSince Nov 11, 2023 Accepting new patients
Donald E. Teagle, OD Optometrist Past Accepting new patients

Locations

8190 Mango Ave
Fontana, CA 92335
Phone (909) 350-2020

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1912260878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8190 MANGO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353610",
            "telephone_number": "909-350-2020",
            "fax_number": "909-350-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8190 MANGO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353610",
            "telephone_number": "909-350-2020",
            "fax_number": "909-350-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CATHY",
        "middle_name": "LINH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.