Provider Demographics
NPI:1326103276
Name:DUONG, VY D (OD)
Entity Type:Individual
Prefix:DR
First Name:VY
Middle Name:D
Last Name:DUONG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1036 E BASTANCHURY RD
Mailing Address - Street 2:B
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2790
Mailing Address - Country:US
Mailing Address - Phone:714-256-2020
Mailing Address - Fax:714-256-2025
Practice Address - Street 1:1036 E BASTANCHURY ROAD
Practice Address - Street 2:B
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-256-2020
Practice Address - Fax:714-256-2025
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA9706T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU51548Medicare UPIN
CAFX811Medicare PIN