MEDICARE: LYNH HOANG NGUYEN O.D., PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	531	NV

General Provider Information

NPI Number	:	1922210988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNH HOANG NGUYEN O.D., PC

Provider Business Mailing Address
First Line	:	9484 BREWING CLOUD AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8020 S RAINBOW BLVD
Second Line	:	SUITE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6483
Country	:	US
Telephone Number	:	702-658-3937
Fax Number	:	702-869-3937

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LYNH H NGUYEN
Credential	:	O.D.
Telephone Number	:	702-273-9898

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	03/23/2008

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