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General NPI Number Information
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NPI Number | 1720421928
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Entity Type | Organization
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Legal Business Name | E OPTOMETRY GROUP, INC.
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 18181 BUTTERFIELD BLVD SUITE 150
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City | MORGAN HILL
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State | CA
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Zip | 95037-8108
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Country | US
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Telephone | 408-779-2000
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Fax | 408-778-2569
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Provider Business Mailing Address
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Address Line | 18181 BUTTERFIELD BLVD SUITE 150
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City | MORGAN HILL
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State | CA
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Zip | 95037-8108
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Country | US
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Telephone | 408-779-2000
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Fax | 408-778-2569
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. TINA DOAN TRUONG
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Credential | OD
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Telephone | 408-515-5748
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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 | OPT14629-TLG
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License Number State | CA
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