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General NPI Number Information
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NPI Number | 1821427394
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Entity Type | Organization
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Legal Business Name | KATELYN NGUYEN, OD, INC
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Dates
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Enumeration Date | 11/05/2013
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 10920 GARFIELD AVE # BA2
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City | SOUTH GATE
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State | CA
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Zip | 90280-7502
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Country | US
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Telephone | 562-861-9098
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Fax |
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Provider Business Mailing Address
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Address Line | 10920 GARFIELD AVE # BA2
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City | SOUTH GATE
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State | CA
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Zip | 90280-7502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KATELYN NGUYEN
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Credential | OD
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Telephone | 714-931-4268
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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 | 12503T
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License Number State | CA
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