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NPI Code Detail

MEDICARE: QUINN Q NGUYEN OPTOMETRY INC

MEDICARE: QUINN Q NGUYEN OPTOMETRY INC
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 11194 TPACA

Other Identifiers

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

General Provider Information

NPI Number : 1588824320
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUINN Q NGUYEN OPTOMETRY INC
Provider Business Mailing Address
First Line : 1111 W ROBINHOOD DR STE E
Second Line :
City : STOCKTON
State : CA
Zip : 95207-5626
Country : US
Telephone Number : 209-476-7040
Fax Number : 209-476-7040
Provider Business Practice Location Address
First Line : 1111 W ROBINHOOD DR STE E
Second Line :
City : STOCKTON
State : CA
Zip : 95207-5626
Country : US
Telephone Number : 209-476-7040
Fax Number : 209-476-7040
Authorized Official
Title or Position : DIRECTOR
Name : DR. QUINN Q NGUYEN
Credential : OD
Telephone Number : 209-476-7040
Provider Enumeration Date : 06/16/2008
Last Update Date : 08/09/2019

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Directions to “QUINN Q NGUYEN OPTOMETRY INC ” Practice Location

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