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General NPI Number Information
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NPI Number | 1891842530
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Entity Type | Individual
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Provider Name | NGOC MONG HOANG NGUYEN O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 1264 AUTO PKWY STE A
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City | ESCONDIDO
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State | CA
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Zip | 92029
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Country | US
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Telephone | 760-743-5209
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Fax |
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Provider Business Mailing Address
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Address Line | 11925 MERIDEN LN
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City | SAN DIEGO
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State | CA
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Zip | 92128-4337
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Country | US
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Telephone | 619-689-0627
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Fax |
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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 | OPT10519
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License Number State | CA
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