Provider Demographics
NPI:1043856487
Name:NGUYEN, HAU ANDY (OD)
Entity Type:Individual
Prefix:
First Name:HAU ANDY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3857 WEST CAMPUS VIEW DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084
Mailing Address - Country:US
Mailing Address - Phone:801-601-3231
Mailing Address - Fax:
Practice Address - Street 1:3857 WEST CAMPUS VIEW DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084
Practice Address - Country:US
Practice Address - Phone:801-601-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34461TLG152W00000X
UT11555545-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist