Healthcare Provider Details

I. General information

NPI: 1538473954
Provider Name (Legal Business Name): NGOC THUY TRINH O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 E COMPTON BLVD
COMPTON CA
90221-3206
US

IV. Provider business mailing address

318 E COMPTON BLVD
COMPTON CA
90221-3206
US

V. Phone/Fax

Practice location:
  • Phone: 310-631-3660
  • Fax:
Mailing address:
  • Phone: 310-631-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13999 TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: