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General NPI Number Information
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NPI Number | 1841703733
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Entity Type | Organization
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Legal Business Name | MILESTONES OPTOMETRY, INC.
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 640 GRAND AVE STE 101
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City | SAN MARCOS
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State | CA
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Zip | 92078-1228
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Country | US
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Telephone | 619-315-8636
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Fax |
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Provider Business Mailing Address
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Address Line | 640 GRAND AVE STE 101
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City | SAN MARCOS
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State | CA
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Zip | 92078-1207
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Country | US
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Telephone | 760-736-0020
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Fax | 760-736-0019
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANNY NGUYEN VANDAN
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Credential | OD
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Telephone | 619-315-8636
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14788
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License Number State | CA
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