Tina Khieu, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34777 Issued in CA

Practice address

5680 Balboa Ave
San Diego, CA 92111-2706

Phone

(858) 278-2837

Fax

(858) 278-2834

NPI assigned

Apr 5, 2020

Last updated

Sep 3, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Chan Family Vision Care Optometric Inc

  • Optometrist
  • Grass Valley, CA
  • NPI 1699323329
  Medicare reassignment NPD
• Retina Institute of California Medical Group, a California Medical Par

  • Ophthalmology Physician
  • Riverside, CA
  • NPI 1770976987

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1962031617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 BALBOA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112706",
            "telephone_number": "858-278-2837",
            "fax_number": "858-278-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 BALBOA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112706",
            "telephone_number": "858-278-2837",
            "fax_number": "858-278-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHIEU",
        "first_name": "TINA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-05",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "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": "CA",
            "license": "34777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhupinder Khehar, M.D.
• Hamid Kheradmandnia, DDS
• Ambika Rashmi Khetarpal
• Vishal Khiatani, MD
• Khiem Mai Medical
• Vivian Thao Khieu
• Cindy Khine
• Sheetal Khiyani, M.D.
• Swapnil Khoche
• Elmira Khodapanah, D.D.S

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.