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General NPI Number Information
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NPI Number | 1760948582
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Entity Type | Individual
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Provider Name | LINDA NGUYEN OD
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Gender | Female
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Dates
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Enumeration Date | 02/17/2019
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Last Update Date | 02/17/2019
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Provider Practice Location Address
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Address Line | 12155 TECH CENTER DR
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City | POWAY
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State | CA
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Zip | 92064-7156
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Country | US
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Telephone | 858-848-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 1565 GRAPEVINE LN
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City | VISTA
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State | CA
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Zip | 92083-5574
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Country | US
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Telephone | 678-982-2325
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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 | OPT34154-TLG
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License Number State | CA
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