MEDICARE: LOI THANH MAI O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	34111	CA
2	152W00000X	Optometrist	894	NV

General Provider Information

NPI Number	:	1902353238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOI THANH MAI O.D.

Provider Business Mailing Address
First Line	:	16106 BELLFLOWER BLVD
Second Line	:
City	:	BELLFLOWER
State	:	CA
Zip	:	90706-4606
Country	:	US
Telephone Number	:	714-724-1540
Fax Number	:	714-716-5525

Provider Business Practice Location Address
First Line	:	16106 BELLFLOWER BLVD
Second Line	:
City	:	BELLFLOWER
State	:	CA
Zip	:	90706-4606
Country	:	US
Telephone Number	:	562-867-4716
Fax Number	:	714-716-5525

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2016
Last Update Date	:	04/28/2026

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