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General NPI Number Information
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NPI Number | 1275769952
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Entity Type | Organization
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Legal Business Name | NGOC-THUY TRINA NGUYEN OD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/08/2009
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 10872 WESTMINSTER AVE STE.112
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4981
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Country | US
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Telephone | 714-636-9585
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Fax | 714-636-2465
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Provider Business Mailing Address
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Address Line | 10872 WESTMINSTER AVE STE.112
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4981
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Country | US
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Telephone | 714-636-9585
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Fax | 714-636-2465
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Authorized Official
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Title or Position | PRESIDENT/ CEO
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Name | NGOC-THUY TRINA NGUYEN
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Credential | O.D.
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Telephone | 714-454-7322
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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 | 9686T
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License Number State | CA
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