Dr Tanya Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR TANYA OPTOMETRY

Practice address

563 N Mountain Ave
Upland, CA 91786-5016

Phone

(909) 985-2876

Fax

(909) 946-8585

NPI assigned

Jan 7, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Lethuy Thi Nguyen, O.D.NPI 1033285689

Title

President

Phone

(909) 985-2876

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mintz Family Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Lethuy T Nguyen, O.D.

  • Optometrist
  • Upland, CA
  • NPI 1033285689
  Medicare reassignment Authorized official
• Matthew Moraton, OD

  • Optometrist
  • Redlands, CA
  • NPI 1992219133
  NPD (past)

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1922420108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865016",
            "telephone_number": "909-985-2876",
            "fax_number": "909-946-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865016",
            "telephone_number": "909-985-2876",
            "fax_number": "909-946-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TANYA OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-07",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "LETHUY",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-985-2876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9953",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0099530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mintz Family Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Upland, CA
• Providers in Upland, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.