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NPI Code Detail

MEDICARE: DR. SON QUANG NGUYEN O.D.

MEDICARE: DR. SON QUANG 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
1152WL0500XLow Vision Rehabilitation Optometrist11835TCA
2152W00000XOptometrist11835TLGCA

General Provider Information

NPI Number : 1962536649
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SON QUANG NGUYEN O.D.
Provider Business Mailing Address
First Line : 318 E COMPTON BLVD
Second Line :
City : COMPTON
State : CA
Zip : 90221-3206
Country : US
Telephone Number : 310-631-3660
Fax Number : 310-631-9264
Provider Business Practice Location Address
First Line : 318 E COMPTON BLVD
Second Line :
City : COMPTON
State : CA
Zip : 90221-3206
Country : US
Telephone Number : 310-631-3660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 01/05/2022

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