Healthcare Provider Details

I. General information

NPI: 1326103276
Provider Name (Legal Business Name): VY D DUONG O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1036 E BASTANCHURY ROAD B
FULLERTON CA
92835
US

IV. Provider business mailing address

14571 MAGNOLIA ST STE 205
WESTMINSTER CA
92683-5576
US

V. Phone/Fax

Practice location:
  • Phone: 714-256-2020
  • Fax: 714-256-2025
Mailing address:
  • Phone: 714-894-4599
  • Fax: 714-897-7367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number9706T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: