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General NPI Number Information
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NPI Number | 1275849887
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Entity Type | Organization
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Legal Business Name | CLEAROPTIX OPTOMETRIC GROUP
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 9972 BOLSA AVE STE 105
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City | WESTMINSTER
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State | CA
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Zip | 92683-6069
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Country | US
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Telephone | 714-210-3405
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Fax | 714-455-1556
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Provider Business Mailing Address
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Address Line | 9972 BOLSA AVE STE 105
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City | WESTMINSTER
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State | CA
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Zip | 92683-6069
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Country | US
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Telephone | 714-210-3405
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Fax | 714-455-1556
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Authorized Official
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Title or Position | OWNER
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Name | HUONG QUOC TRANG
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Credential | OD
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Telephone | 714-210-3405
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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 | 14011TLG
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License Number State | CA
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