Active NPI
Victor Gin, OD
- Optometrist
- Fremont, CA
National Provider Identifier
1972562098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5527T
- Practice address
- 39355 California St Suite 103
Fremont, CA 94538-1447 - Phone
- (510) 744-2010
- Fax
- (510) 744-2015
- NPI assigned
- Mar 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5527T | CA | Primary |
Addresses
Primary practice location
39355 California St Suite 103
Fremont, CA 94538-1447
Mailing address
39355 California St Suite 103
Fremont, CA 94538-1447
Phone (510) 744-2010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0022890 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5527T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fremont Optometric Group | Optometrist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Optometrist
- Fremont, CA
- NPI 1619991080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1972562098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39355 CALIFORNIA ST SUITE 103",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381447",
"telephone_number": "510-744-2010",
"fax_number": "510-744-2015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39355 CALIFORNIA ST SUITE 103",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381447",
"telephone_number": "510-744-2010",
"fax_number": "510-744-2015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIN",
"first_name": "VICTOR",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-18",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5527T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0022890",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.