Healthcare Provider Details

I. General information

NPI: 1871615328
Provider Name (Legal Business Name): THUY U HUA O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 JAMBOREE RD SUITE 1100
NEWPORT BEACH CA
92660-2939
US

IV. Provider business mailing address

3501 JAMBOREE RD SUITE 1100
NEWPORT BEACH CA
92660-2939
US

V. Phone/Fax

Practice location:
  • Phone: 949-854-7400
  • Fax: 949-854-7331
Mailing address:
  • Phone: 949-854-7400
  • Fax: 949-854-7331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT10110T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: