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General NPI Number Information
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NPI Number | 1760971402
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Entity Type | Individual
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Provider Name | VU NGUYEN OD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 17230 NEWHOPE ST APT 104
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-8211
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Country | US
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Telephone | 408-472-7037
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Fax |
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Provider Business Mailing Address
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Address Line | 2860 S BRISTOL ST STE D
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City | SANTA ANA
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State | CA
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Zip | 92704-6200
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Country | US
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Telephone | 714-540-3993
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Fax | 844-231-8874
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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 | OPT33914-TLG
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License Number State | CA
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