Healthcare Provider Details

I. General information

NPI: 1801462056
Provider Name (Legal Business Name): TUYEN HUYNH, OD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2021
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 TIERRA REJADA RD
SIMI VALLEY CA
93065-2902
US

IV. Provider business mailing address

51 TIERRA REJADA RD
SIMI VALLEY CA
93065-2902
US

V. Phone/Fax

Practice location:
  • Phone: 805-568-8058
  • Fax:
Mailing address:
  • Phone: 805-568-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TUYEN HUYNH
Title or Position: OPTOMETRIST
Credential: OD
Phone: 805-568-8058