Healthcare Provider Details

I. General information

NPI: 1164908679
Provider Name (Legal Business Name): CINDY TRINH OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7361 W LAKE MEAD BLVD STE 104
LAS VEGAS NV
89128-1040
US

IV. Provider business mailing address

7209 CALIFORNIA BLVD NE
CALGARY AB
T1Y6X8
CA

V. Phone/Fax

Practice location:
  • Phone: 702-452-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number984
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: