Individual provider Active NPI

Eng Ann Sung, OD

  • Optometrist
  • San Diego, CA
National Provider Identifier
1912533134
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34533 Issued in CA
Practice address
8225 Guppy CT
San Diego, CA 92129-3760
Phone
(858) 527-5882
NPI assigned
Mar 19, 2020
Last updated
Aug 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X 10081 TX
Optometrist 152W00000X 34533 CA Primary

Addresses

Primary practice location

8225 Guppy CT
San Diego, CA 92129-3760

Mailing address

8225 Guppy CT
San Diego, CA 92129-3760
Phone (858) 527-5882

Other practice location 1

4901 Calhoun Rd
Houston, TX 77204-3760
Phone (713) 743-1921

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
I20211115000636 CA Practitioner - Optometry 5799104873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wan and Mashouf Optometric Corp PCGroup PAC ID 7315347432, 4 clinicians

Practice addresses (Care Compare)

10549 Scripps Poway Pkwy
Suite G
San Diego, CA 92131-3963
Phone (858) 530-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34533CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Wan and Mashouf Optometric Corp PC Optometrist CurrentSince Oct 1, 2021 Accepting new patients

Locations

10549 Scripps Poway Pkwy
Ste G
San Diego, CA 92131
Phone (858) 530-2800

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": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1912533134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8225 GUPPY CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293760",
            "telephone_number": "858-527-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 GUPPY CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293760",
            "telephone_number": "858-527-5882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Calhoun Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "772043760",
            "country_code": "US",
            "telephone_number": "713-743-1921",
            "fax_number": "713-743-0963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUNG",
        "first_name": "ENG ANN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10081",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.