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General NPI Number Information
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NPI Number | 1770920407
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Entity Type | Organization
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Legal Business Name | DOWNTOWN VACAVILLE EYECARE, INC AN OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 340 CERNON ST
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City | VACAVILLE
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State | CA
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Zip | 95688-4502
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Country | US
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Telephone | 707-446-2090
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Fax | 707-446-4406
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Provider Business Mailing Address
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Address Line | 340 CERNON ST
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City | VACAVILLE
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State | CA
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Zip | 95688-4502
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Country | US
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Telephone | 707-446-2090
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Fax | 707-446-4406
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Authorized Official
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Title or Position | CEO
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Name | DR. HANG T NHAN
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Credential | OD
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Telephone | 707-446-2090
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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 | 11196T
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License Number State | CA
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