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NPI Code Detail

MEDICARE: DR. MICHELLE NGUYEN KIRK O.D.

MEDICARE: DR. MICHELLE NGUYEN KIRK 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
1152W00000XOptometristOPT 14393 TLGCA

General Provider Information

NPI Number : 1477818235
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE NGUYEN KIRK O.D.
Provider Business Mailing Address
First Line : 10088 ADAMS AVE
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-4905
Country : US
Telephone Number : 714-962-9377
Fax Number :
Provider Business Practice Location Address
First Line : 10088 ADAMS AVE
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-4905
Country : US
Telephone Number : 714-962-9377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2012
Last Update Date : 07/09/2012

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