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General NPI Number Information
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NPI Number | 1932835956
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Entity Type | Individual
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Provider Name | NINA HUE VAN OD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 1183 S DE ANZA BLVD STE 50
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City | SAN JOSE
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State | CA
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Zip | 95129-3659
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Country | US
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Telephone | 408-366-1681
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Fax | 408-366-1680
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Provider Business Mailing Address
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Address Line | 250 BALDWIN AVE APT 308
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City | SAN MATEO
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State | CA
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Zip | 94401-3900
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Country | US
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Telephone | 562-912-9264
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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 | 10564
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License Number State | TX
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