Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ethan S Diep, OD

Individual provider Optometrist · NPI 1639467467

Dr. Ethan S Diep, OD is an Optometry in Chula Vista, California. Graduated from Southern California College of Optometry in 2011, 15 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
15
Trained at
Southern California College of Optometry
Licensed in
CA
In the registry since
2011
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

878 Eastlake Pkwy Ste 1011
Chula Vista, CA 91914-4546
Phone: (619) 216-4582
Fax: (619) 216-4589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 14173 (CA)

Record details

NPI number1639467467
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedJuly 14, 2011
Last updated in NPPESDecember 1, 2021
Certification dateDecember 1, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolSOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduated 2011 (15 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Chula Vista