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NPI Code Detail

MEDICARE: DR. THANH BINH THI NGUYEN O.D.

MEDICARE: DR. THANH BINH THI 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
1152W00000XOptometrist13988CA

General Provider Information

NPI Number : 1588970321
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THANH BINH THI NGUYEN O.D.
Provider Business Mailing Address
First Line : 2893 E VIA TERRANO
Second Line :
City : ONTARIO
State : CA
Zip : 91764-6557
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 701 RIO RANCHO RD
Second Line :
City : POMONA
State : CA
Zip : 91766-7018
Country : US
Telephone Number : 909-620-7920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2010
Last Update Date : 03/10/2014

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