Healthcare Provider Details

I. General information

NPI: 1760396162
Provider Name (Legal Business Name): TRACEY DANG NGUYEN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3144 EL CAMINO REAL STE 202
CARLSBAD CA
92008-2194
US

IV. Provider business mailing address

3144 EL CAMINO REAL STE 202
CARLSBAD CA
92008-2194
US

V. Phone/Fax

Practice location:
  • Phone: 760-434-3314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36398
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: