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General NPI Number Information
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NPI Number | 1588970321
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Entity Type | Individual
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Provider Name | THANH BINH THI NGUYEN O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 701 RIO RANCHO RD
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City | POMONA
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State | CA
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Zip | 91766-7018
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Country | US
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Telephone | 909-620-7920
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Fax |
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Provider Business Mailing Address
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Address Line | 2893 E VIA TERRANO
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City | ONTARIO
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State | CA
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Zip | 91764-6557
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Country | US
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Telephone |
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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 | 13988
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License Number State | CA
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