MEDICARE: DR. NGHI UYEN DUONG 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	12803	CA

General Provider Information

NPI Number	:	1285832501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NGHI UYEN DUONG O.D.

Provider Business Mailing Address
First Line	:	635B S RANCHO SANTA FE RD
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92078-3973
Country	:	US
Telephone Number	:	760-744-0767
Fax Number	:	760-744-2892

Provider Business Practice Location Address
First Line	:	5330 CARROLL CANYON RD STE 210
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3758
Country	:	US
Telephone Number	:	858-450-1010
Fax Number	:	858-450-9451

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

Provider Enumeration Date	:	07/09/2007
Last Update Date	:	02/20/2025

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