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

Mark Soontornvachrin

Individual provider Ophthalmology Physician · NPI 1609987585

Mark Soontornvachrin is an Ophthalmology in Vista, California. Qualified in 2005, 21 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
21
Licensed in
CA
In the registry since
2006
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Practice location Address checks out

780 Shadowridge Dr
Vista, CA 92083-7986
Phone: (844) 424-1867
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence A112148 (CA)

Record details

NPI number1609987585
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 31, 2006
Last updated in NPPESNovember 30, 2021
Mailing address780 Shadowridge Dr, Vista, CA 92083-7986

Medicare enrollment

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

Medicare specialtyOPHTHALMOLOGY
Medical schoolOTHER
Graduated 2005 (21 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 Vista