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General NPI Number Information
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NPI Number | 1861769135
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Entity Type | Organization
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Legal Business Name | KIM O NGUYEN O D INC
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 25401 ALICIA PKWY SUITE E
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-4958
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Country | US
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Telephone | 949-951-8001
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Fax | 959-951-1552
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Provider Business Mailing Address
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Address Line | 25401 ALICIA PKWY STE E
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-4958
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Country | US
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Telephone | 949-951-8001
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Fax | 959-951-1552
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KIM OANH NGUYEN
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Credential | O.D.
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Telephone | 949-951-8001
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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 | OPT11972
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License Number State | CA
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