Healthcare Provider Details

I. General information

NPI: 1861557712
Provider Name (Legal Business Name): TU D DOAN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 LONG BEACH BLVD STE 400
LONG BEACH CA
90807-2008
US

IV. Provider business mailing address

6931 VIA IRANA
STANTON CA
90680-1924
US

V. Phone/Fax

Practice location:
  • Phone: 562-591-7700
  • Fax: 562-591-1311
Mailing address:
  • Phone: 714-785-1363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13009
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: