Healthcare Provider Details

I. General information

NPI: 1689564486
Provider Name (Legal Business Name): WILLIAM DOAN NGUYEN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2025
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 ILLINOIS ST
SAN FRANCISCO CA
94158
US

IV. Provider business mailing address

1825 4TH ST UCSF MEDICAL CENTER, PEDS OPHTHALMOLOGY BOX 0735
SAN FRANCISCO CA
94143-2350
US

V. Phone/Fax

Practice location:
  • Phone: 415-530-6123
  • Fax:
Mailing address:
  • Phone: 415-530-6123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number011250
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36323
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011250
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: