Individual provider Active NPI

Tim Hung Minh Nguyen, O.D., M.P.H.

  • Optometrist
  • Westminster, CA
National Provider Identifier
1972667079
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12458T Issued in CA
Practice address
7841 Westminster Blvd
Westminster, CA 92683-4033
Phone
(714) 893-4560
Fax
(714) 893-0340
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12458T CA Primary

Addresses

Primary practice location

7841 Westminster Blvd
Westminster, CA 92683-4033

Mailing address

7841 Westminster Blvd
Westminster, CA 92683-4033
Phone (714) 893-4560

Other identifiers 1

IdentifierTypeStateIssuer
GSD004970MedicaidCA

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
I20040408001297 CA Practitioner - Optometry 5597656769 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12458TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
United Eye Care Optometry, Inc. Optometrist CurrentSince May 1, 2004 Accepting new patients

Locations

7841 Westminster Blvd
Westminster, CA 92683
Phone (714) 893-4560

14072 Magnolia St
Ste 106
Westminster, CA 92683
Phone (714) 741-3937

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1972667079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7841 WESTMINSTER BLVD",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834033",
            "telephone_number": "714-893-4560",
            "fax_number": "714-893-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7841 WESTMINSTER BLVD",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834033",
            "telephone_number": "714-893-4560",
            "fax_number": "714-893-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TIM",
        "middle_name": "HUNG MINH",
        "name_prefix": "Dr.",
        "credential": "O.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12458T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.