Provider Demographics
NPI:1316577562
Name:VALLEY OPTOMETRY PC
Entity Type:Organization
Organization Name:VALLEY OPTOMETRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHINH
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:209-952-4647
Mailing Address - Street 1:87 W MARCH LN STE 2
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5731
Mailing Address - Country:US
Mailing Address - Phone:209-952-4647
Mailing Address - Fax:
Practice Address - Street 1:87 W MARCH LN STE 2
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5731
Practice Address - Country:US
Practice Address - Phone:209-952-4647
Practice Address - Fax:209-952-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty