Organization Active NPI

Mindy D. Trinh OD Inc

Doing business as Evergreen Valley Optometry

  • Optometrist
  • San Jose, CA
National Provider Identifier
1952574501
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12629T Issued in CA
Legal business name
MINDY D. TRINH OD INC
Doing business as
Evergreen Valley Optometry
Practice address
3257 S White Rd
San Jose, CA 95148-4056
Phone
(408) 238-9696
Fax
(408) 238-4067
NPI assigned
Apr 3, 2008
Last updated
Feb 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Authorized official

Name
Dr. Mindy Dieuminh TrinhNPI 1962555789
Title
President
Phone
(408) 238-9696

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 12629T CA Primary

Addresses

Primary practice location

3257 S White Rd
San Jose, CA 95148-4056

Mailing address

3257 S White Rd
San Jose, CA 95148-4056
Phone (408) 238-9696

Other names 1

  • Evergreen Valley Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081217000290 CA Part B Supplier - Clinic/Group Practice 8628130119 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

3257 S White Rd
San Jose, CA 95148
Phone (408) 238-9696

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1952574501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3257 S WHITE RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951484056",
            "telephone_number": "408-238-9696",
            "fax_number": "408-238-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3257 S WHITE RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951484056",
            "telephone_number": "408-238-9696",
            "fax_number": "408-238-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDY D. TRINH OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "TRINH",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "DIEUMINH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-238-9696",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12629T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Valley Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.