Provider Demographics
NPI:1043574742
Name:NGUYEN, ROSANNA T (OD)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27420 TOURNEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5631
Mailing Address - Country:US
Mailing Address - Phone:661-259-3937
Mailing Address - Fax:661-259-3904
Practice Address - Street 1:27420 TOURNEY RD STE 100
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5631
Practice Address - Country:US
Practice Address - Phone:661-259-3937
Practice Address - Fax:661-259-3904
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14398152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist