Healthcare Provider Details

I. General information

NPI: 1972512176
Provider Name (Legal Business Name): ADVANCED EYE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JOSE FIGUERES AVE SUITE 350
SAN JOSE CA
95116-1585
US

IV. Provider business mailing address

200 JOSE FIGUERES AVE SUITE 350
SAN JOSE CA
95116-1585
US

V. Phone/Fax

Practice location:
  • Phone: 408-923-8138
  • Fax: 408-923-8214
Mailing address:
  • Phone: 408-923-8138
  • Fax: 408-923-8214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG805730
License Number StateCA

VIII. Authorized Official

Name: DR. DANNY BINH LUONG
Title or Position: CEO
Credential: M.D.
Phone: 408-923-8138