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General NPI Number Information
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NPI Number | 1275651408
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Entity Type | Individual
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Provider Name | ANDREA CHAU NGUYEN O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 26502 TOWNE CENTRE DR
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City | FOOTHILL RANCH
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State | CA
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Zip | 92610-2417
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Country | US
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Telephone | 949-588-7520
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Fax | 949-588-6082
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Provider Business Mailing Address
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Address Line | 10164 CARDINAL AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7402
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Country | US
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Telephone | 714-968-9120
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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 | 12628
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License Number State | CA
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