Healthcare Provider Details

I. General information

NPI: 1710782164
Provider Name (Legal Business Name): HOWARD QUACH OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13662 JAMBOREE RD STE A
IRVINE CA
92602-1224
US

IV. Provider business mailing address

13467 WHITTIER LN
GARDEN GROVE CA
92844-2203
US

V. Phone/Fax

Practice location:
  • Phone: 714-508-4975
  • Fax:
Mailing address:
  • Phone: 714-655-1940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36236
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: