MAYO RETINA, INC. (NPI# 1851561716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851561716 |
| Entity Type | Organization |
| Organization Name | MAYO RETINA, INC. |
| Practice Address |
16543 Brookhurst St Fountain Valley CA 92708-2343 |
| Mailing Address |
322 12th St Huntington Beach CA 92648-4519 |
| Practice Telephone | 7144758612 |
| Mailing Telephone | 7144758612 |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2008-03-07 |
| Authorized Official Name | DR. KATHERINE MAYO (PRESIDENT) |
| Authorized Official Telephone | 7144758612 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
20A9551 | CA | Ambulatory Health Care Facilities |
| Y | 261QS0132X |
Clinic/Center Specialization: Ophthalmologic Surgery |
G83501 | CA | Ambulatory Health Care Facilities |
| Street Address |
16543 BROOKHURST ST |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708-2343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154397768 | Kevin Khai Tuan Tieu | Obstetrics & Gynecology | 16543 Brookhurst St, Fountain Valley, CA 92708-2343 | 2006-02-23 |
| 1285086686 | Tarryn Thuytien Tran | Physician Assistant | 16543 Brookhurst St, Fountain Valley, CA 92708-2343 | 2016-07-08 |
| 1972998094 | Thanh Thi Phuong Nguyen | Nurse Practitioner | 16543 Brookhurst St, Fountain Valley, CA 92708-2343 | 2015-04-06 |
| 1407282510 | Triet Minh Le | Obstetrics & Gynecology | 16543 Brookhurst St, Fountain Valley, CA 92708-2343 | 2013-09-20 |
| 1316014152 | Katherine A. Mayo | Obstetrics & Gynecology | 16543 Brookhurst St, Fountain Valley, CA 92708-2343 | 2006-11-29 |
| 1174693881 | Kevin Khai Tieu Md A Professional Corporation | Obstetrics & Gynecology | 16543 Brookhurst St, Fountain Valley, CA 92708-2343 | 2006-11-09 |
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|---|---|---|---|---|
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| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
| 1659864338 | Orange County Respiratory Physicians Corp | Internal Medicine | 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 | 2018-06-07 |
| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
| 1144746348 | Goose Pharma, LLC | Pharmacy | 18049 Magnolia Street, Fountain Valley, CA 92708 | 2017-08-18 |
| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
| 1942722129 | Graph Surgery Inc | Plastic Surgery | 10760 Warner Ave, Ste 201, Fountain Valley, CA 92708 | 2017-07-10 |
| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
| Find all providers in zip 92708 | ||||
| Taxonomy Code | 261QS0132X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ophthalmologic Surgery |
| Definition to come... |
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| 1437565298 | Dr. Barbara S. Yates, Inc. | Clinic/Center | 4804 Laurel Canyon Blvd # 1200, Valley Village, CA 91607-3717 | 2014-07-01 |
| 1770865735 | Vision Institute of Southern California A Professional Medical Corpora | Clinic/Center | 18725 Gale Ave Ste 140, City of Industry, CA 91748-1358 | 2011-09-15 |
| 1548583255 | Gold Coast Vision LLC | Clinic/Center | 461 W 5th St, Oxnard, CA 93030-7049 | 2010-03-09 |
| 1942523139 | Advanced Laser Center | Clinic/Center | 350 S Winchester Blvd, Suite 250, San Jose, CA 95128-2092 | 2010-03-02 |
| 1447485156 | Humboldt Physicians Surgery and Laser Center LLC | Clinic/Center | 3226 Timber Fall Court, Eureka, CA 95503-4888 | 2009-05-26 |
| Find all providers with the same taxonomy | ||||
| City | FOUNTAIN VALLEY |
| Zip Code | 92708 |
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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.