Provider Demographics
NPI:1497526743
Name:GIAP LE OD INC
Entity Type:Organization
Organization Name:GIAP LE OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO,CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:GIAP
Authorized Official - Middle Name:NGUYEN
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-232-6139
Mailing Address - Street 1:17532 TEACHERS AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6654
Mailing Address - Country:US
Mailing Address - Phone:949-232-6139
Mailing Address - Fax:
Practice Address - Street 1:2595 E IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6129
Practice Address - Country:US
Practice Address - Phone:714-672-9077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty