MEDICARE: BARBARA-DINH NGUYEN OD

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	35379	CA

General Provider Information

NPI Number	:	1548976988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA-DINH NGUYEN OD

Provider Business Mailing Address
First Line	:	2025 NOTRE DAME AVE
Second Line	:
City	:	BELMONT
State	:	CA
Zip	:	94002-1750
Country	:	US
Telephone Number	:	415-505-2502
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 EL CAMINO REAL STE 235
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3213
Country	:	US
Telephone Number	:	650-259-0300
Fax Number	:

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

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	04/27/2023

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