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Physician Compare National (NPI:1316103633)

HEALTHCARE PROVIDER: CINDY QUYEN THAN O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1316103633
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0648462689
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20190531001517
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name THAN
Individual professional last name
Provider First Name CINDY
Individual professional first name
Provider Middle Name QUYEN
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name NEW ENGLAND COLLEGE OF OPTOMETRY
Individual professional's medical school
Graduation Year 2008
Individual professional's medical school graduation year
Primary Specialty OPTOMETRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address NAVY AIR STATION N ISLAND
Group Practice or individual's line 1 address
Line 2 Street Address BUILDING 2017
Group Practice or individual's line 2 address
City SAN DIEGO
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 92135
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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