Provider Demographics
NPI:1447386073
Name:DANG, TONY NGUYEN (OD)
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:NGUYEN
Last Name:DANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:NGUYEN
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:477 E COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2024
Mailing Address - Country:US
Mailing Address - Phone:626-796-1191
Mailing Address - Fax:626-796-0189
Practice Address - Street 1:477 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2024
Practice Address - Country:US
Practice Address - Phone:626-796-1191
Practice Address - Fax:626-796-0189
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13185TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist