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General NPI Number Information
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NPI Number | 1376831057
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Entity Type | Organization
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Legal Business Name | DAWN THANH VU, OD, AN OPTOMETRIC PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 01/15/2023
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Provider Practice Location Address
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Address Line | 700 W 1ST ST STE 1
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City | TUSTIN
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State | CA
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Zip | 92780-2948
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Country | US
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Telephone | 714-547-6819
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Fax | 714-547-6070
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Provider Business Mailing Address
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Address Line | 700 W 1ST ST STE 1
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City | TUSTIN
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State | CA
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Zip | 92780-2948
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Country | US
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Telephone | 714-547-6819
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Fax | 714-547-6070
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAWN THANH VU
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Credential | OD
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Telephone | 714-357-7950
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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 | 12373T
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License Number State | CA
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