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General NPI Number Information
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NPI Number | 1609007533
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Entity Type | Individual
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Provider Name | NGUYEN HUNG QUACH O.D
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Gender | Male
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 11/05/2015
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Provider Practice Location Address
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Address Line | 1880 PRAIRIE CITY RD SUITE 130
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City | FOLSOM
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State | CA
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Zip | 95630-9593
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Country | US
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Telephone | 916-985-7848
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Fax | 888-789-4512
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Provider Business Mailing Address
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Address Line | 734 LEFEVRE CT
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City | FOLSOM
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State | CA
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Zip | 95630-6188
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Country | US
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Telephone | 530-723-4005
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Fax | 888-789-5412
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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 | 13774
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License Number State | CA
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