NICOLE-NINCHO PHU HA (NPI# 1609992940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609992940 |
| Entity Type | Individual |
| Full Name | NICOLE-NINCHO PHU HA |
| Credential | O.D. |
| Practice Address |
4605 Brockton Ave Suite 100 Riverside CA 92506-0106 |
| Practice Telephone | 9516864911 |
| Practice Fax Number | 9516869409 |
| Mailing Telephone | 9516864911 |
| Mailing Fax Number | 9516869409 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2009-02-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT 10694T | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LICENSE | OPT 10694T | 01 |
| CA | SD0106940 | 05 |
| Street Address |
4605 BROCKTON AVE SUITE 100 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92506-0106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164484507 | Ray Rogers Glendrange | Ophthalmology | 4605 Brockton Ave, Suite 100, Riverside, CA 92506-0106 | 2006-04-03 |
| 1356745749 | Aileen Barragan | Physician Assistant | 4605 Brockton Ave, Ste 200, Riverside, CA 92506-0106 | 2014-10-15 |
| 1316010499 | Riverside Plastic Surgery Associates Inc. | Specialist | 4605 Brockton Ave, Suite 200, Riverside, CA 92506-0106 | 2006-11-16 |
| 1932287471 | Ben J. Childers | Specialist | 4605 Brockton Ave, Suite 200, Riverside, CA 92506-0106 | 2006-11-01 |
| 1740242627 | John J Allavie | Ophthalmology | 4605 Brockton Ave, Suite 100, Riverside, CA 92506-0107 | 2006-04-05 |
| 1508828963 | Riverside Eye Specialists Medical Group Inc. | Ophthalmology | 4605 Brockton Ave, Suite 100, Riverside, CA 92506-0106 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405715 | Riverside Primary Care Clinic, Joanna Ayala Md | Clinic/Center | 3978 Merrill Ave, Riverside, CA 92506 | 2020-10-22 |
| 1336747005 | Beatriz Arredondo | Behavioral Analyst | 6117 Brockton Avenue Ste. 202, Riverside, CA 92506 | 2020-10-14 |
| 1740756782 | Priscilla Marie Rodriguez | Social Worker | 3742 Tibbets St Suite 201, Riverside, CA 92506 | 2018-10-17 |
| 1922593946 | Prevail Health Solutions, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 7450 Chateau Ridge Ln, Riverside, CA 92506 | 2018-06-22 |
| 1831691880 | Mckinley Children's Center | Community/Behavioral Health | 6700 Indiana Avenue, Suite 280, Riverside, CA 92506 | 2018-03-06 |
| 1720590946 | Leticia Dilworth | Behavioral Analyst | 3610 Central Ave Ste 46, Riverside, CA 92506 | 2017-10-27 |
| 1548771736 | Usa Biosciences LLC | Clinical Medical Laboratory | 5750 Division St Ste 109, Riverside, CA 92506 | 2017-10-16 |
| 1922542273 | Yazmar Sevilla-perez | Physical Therapist | 6852 Brockton Ave., Suite 212, Riverside, CA 92506 | 2016-12-06 |
| 1821547605 | Pathway To Healing, Marriage and Family Therapy, Inc. | Marriage & Family Therapist | 5790 Magnolia Ave., Ste 202, Rm F, Riverside, CA 92506 | 2016-09-22 |
| 1952857542 | Kramer and Nguyen Dental Corporation | Dentist | 3602 Riverside Plaza Dr, Ste 101, Riverside, CA 92506 | 2016-09-01 |
| Find all providers in zip 92506 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194203398 | Penn Tran Od, Inc | Optometrist | 1299 University Ave Ste 103, Riverside, CA 92507-7236 | 2018-07-31 |
| 1679020283 | Pritesh Patel | Optometrist | 4030 Madison St, Riverside, CA 92504-2642 | 2016-09-01 |
| 1447644893 | Richard P Bozner Od Inc | Optometrist | 4212 Market St, Riverside, CA 92501-3516 | 2015-03-24 |
| 1770976987 | Retina Institute of California | Optometrist | 6906 Brockton Ave, Ste. 6, Riverside, CA 92506-4090 | 2015-03-12 |
| 1902295132 | Oxygen Optometry, Inc | Optometrist | 2712 Canyon Springs Pkwy, Suite A4, Riverside, CA 92507-0938 | 2015-01-12 |
| 1164837183 | Al Vincent D. Romero, O.d. Inc. | Optometrist | 9496 Magnolia Ave Ste 102, Riverside, CA 92503-3733 | 2014-06-27 |
| 1275808115 | Duong D Nguyen, Inc | Optometrist | 5051 Canyon Crest Dr Ste 102, Riverside, CA 92507-6035 | 2012-03-10 |
| 1750679171 | Jessica Duong | Optometrist | 4294 Riverwalk Pkwy, Suite 204, Riverside, CA 92505-8508 | 2011-07-19 |
| 1508185554 | Jerry P Gibson | Optometrist | 3140 White Oak Cr, Riverside, IA 52327 | 2010-05-28 |
| 1023248770 | Dr Harold Krajian Od Inc | Optometrist | 9496 Magnolia Ave, 102, Riverside, CA 92503-3733 | 2009-07-15 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.