Individual provider Active NPI

Son Quang Nguyen, O.D.

  • Optometrist
  • Compton, CA
National Provider Identifier
1962536649
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11835TLG Issued in CA
Practice address
318 E Compton Blvd
Compton, CA 90221-3206
Phone
(310) 631-3660
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 11835T CA
Optometrist 152W00000X 11835TLG CA Primary

Addresses

Primary practice location

318 E Compton Blvd
Compton, CA 90221-3206

Mailing address

318 E Compton Blvd
Compton, CA 90221-3206
Phone (310) 631-3660

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
I20040121001173 CA Practitioner - Optometry 6305748278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compton Eyecare Optometry IncGroup PAC ID 6901200203, 2 clinicians

Practice addresses (Care Compare)

318 E Compton Blvd
Compton, CA 90221-3206
Phone (310) 631-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11835TLGCAMDOptometrist
11835TCAMDLow Vision Rehabilitation Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Compton Eyecare Optometry Inc Optometrist CurrentSince Jun 16, 2021 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

318 E Compton Blvd
Compton, CA 90221
Phone (310) 631-3660

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1962536649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 E COMPTON BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902213206",
            "telephone_number": "310-631-3660",
            "fax_number": "310-631-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 E COMPTON BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902213206",
            "telephone_number": "310-631-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "SON",
        "middle_name": "QUANG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "11835T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11835TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

Verify at the official NPI Registry.