Provider Demographics
NPI:1376839019
Name:NGUYEN, BRUCE CHAU (OD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:CHAU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:CHAU
Other - Middle Name:MINH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9353 CLAIREMONT MESA BLVD
Mailing Address - Street 2:STE K2
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1220
Mailing Address - Country:US
Mailing Address - Phone:714-530-4167
Mailing Address - Fax:714-530-4260
Practice Address - Street 1:9353 CLAIREMONT MESA BLVD
Practice Address - Street 2:STE K2
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1220
Practice Address - Country:US
Practice Address - Phone:858-279-6500
Practice Address - Fax:858-225-7174
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14156152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist