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

Kevin Thanh Phong Nguyen

Individual provider Optometrist · NPI 1134806953

Kevin Thanh Phong Nguyen is an Optometry in Beverly Hills, California. Graduated from Southern California College of Optometry in 2023, 3 years ago. Practices with Peter J Cornell M D Inc, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
3
Trained at
Southern California College of Optometry
Licensed in
CA
In the registry since
2023
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Practice location Address checks out

450 N Bedford Dr # 3101
Beverly Hills, CA 90210-4324
Phone: (310) 274-9205
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 35550 (CA)

Record details

NPI number1134806953
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 3, 2023
Last updated in NPPESJuly 3, 2024
Certification dateJuly 3, 2024

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolSOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduated 2023 (3 years in practice)
Group practice Peter J Cornell M D Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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