Healthcare Provider Details

I. General information

NPI: 1134039464
Provider Name (Legal Business Name): NGUYEN-TRAN & LEE OPTOMETRIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2069 MOUNTAIN BLVD
OAKLAND CA
94611-2815
US

IV. Provider business mailing address

4770 FAIR AVE
OAKLAND CA
94619-2963
US

V. Phone/Fax

Practice location:
  • Phone: 510-339-9318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: THANHAN NGUYEN-TRAN
Title or Position: PRESIDENT
Credential: OD
Phone: 825-431-1605