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General NPI Number Information
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NPI Number | 1952336927
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Entity Type | Individual
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Provider Name | LAURA NGUYEN O.D
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 444 S WATERMAN AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-1518
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Country | US
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Telephone | 909-890-0015
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Fax | 909-890-0323
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Provider Business Mailing Address
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Address Line | 444 S. WATERMAN AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-1545
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Country | US
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Telephone | 909-890-0015
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Fax | 909-890-0323
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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 | 10794T
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License Number State | CA
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