Provider Demographics
NPI:1356095293
Name:NGUYEN VU EYE ASSOCIATES, INC
Entity Type:Organization
Organization Name:NGUYEN VU EYE ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAN
Authorized Official - Middle Name:HUY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-743-8362
Mailing Address - Street 1:9629 RIDGEROCK DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4461
Mailing Address - Country:US
Mailing Address - Phone:916-743-8362
Mailing Address - Fax:
Practice Address - Street 1:1800 CAVITT DR
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6235
Practice Address - Country:US
Practice Address - Phone:916-983-1148
Practice Address - Fax:916-983-1192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33367TLGOtherCA STATE BOARD OF OPTOMETRY
CA33366TLGOtherCA STATE BOARD OF OPTOMETRY