MEDICARE: DR. HELENA H.P NGUYEN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	10036T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265581623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELENA H.P NGUYEN O.D.

Provider Business Mailing Address
First Line	:	3480 EL CAMINO REAL
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-2809
Country	:	US
Telephone Number	:	408-247-5102
Fax Number	:	408-247-5946

Provider Business Practice Location Address
First Line	:	3480 EL CAMINO REAL
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-2809
Country	:	US
Telephone Number	:	408-247-5102
Fax Number	:	408-247-5946

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	06/25/2013

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