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General NPI Number Information
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NPI Number | 1023508363
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Entity Type | Individual
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Provider Name | MOLLY DUONG OD
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Gender | Female
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 5343 RIVERSIDE DR
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City | CHINO
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State | CA
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Zip | 91710-4252
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Country | US
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Telephone | 909-285-9429
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Fax |
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Provider Business Mailing Address
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Address Line | 421 S ASTELL AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-3116
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Country | US
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Telephone | 626-476-8805
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 34200TLG
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License Number State | CA
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