{"npi":"1104371343","type":"NPI-2","status":"active","name":{"display":"Pinhkeo Southaphanh O D INC","other":[],"organization_name":"PINHKEO SOUTHAPHANH O D INC","authorised_official":"Pinhkeo Southaphanh"},"specialty":{"primary_taxonomy":"152W00000X","primary_taxonomy_description":"Optometrist","slug":"optometrist","schema_org_specialty":null,"all":[{"code":"152W00000X","description":"Optometrist","primary":true,"state":"CA","license":"12359TLG"}]},"addresses":[{"purpose":"LOCATION","street_1":"415 E OCEAN AVE STE B","city":"LOMPOC","state":"CA","postal_code":"934366839","country_code":"US","phone":"8058190742","fax":"8057417367"},{"purpose":"MAILING","street_1":"415 E OCEAN AVE STE B","city":"LOMPOC","state":"CA","postal_code":"934366839","country_code":"US","phone":"8058190742","fax":"8057417367"}],"license":{"state":"CA","number":"12359TLG"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1538139381","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20170313001564","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CA","pac_id":"7719262708"}]},"enumeration_date":"2016-08-17","last_updated":"2024-07-22","_meta":{"source":"NPPES","snapshot_date":"2024-07-22","doc_url":"https://findmynpi.com/api"}}