Provider Demographics
NPI:1134680804
Name:NGUYEN, UYEN (OD)
Entity Type:Individual
Prefix:DR
First Name:UYEN
Middle Name:
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 1:18725 GALE AVENUE, SUITE 140
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1358
Mailing Address - Country:US
Mailing Address - Phone:626-854-2020
Mailing Address - Fax:626-854-2021
Practice Address - Street 1:18725 GALE AVENUE, SUITE 140
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1358
Practice Address - Country:US
Practice Address - Phone:626-854-2020
Practice Address - Fax:626-854-2021
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12517152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist