Provider Demographics
NPI:1497479075
Name:LE, VIVIAN TU-ANH (OD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:TU-ANH
Last Name:LE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 FOX HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-3454
Mailing Address - Country:US
Mailing Address - Phone:408-824-0607
Mailing Address - Fax:
Practice Address - Street 1:7526 MONTEREY ST
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-5826
Practice Address - Country:US
Practice Address - Phone:408-457-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT35174-TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist