Provider Demographics
NPI:1497947311
Name:LE-HUYNH, KIM NHAT NGUYEN (OD)
Entity Type:Individual
Prefix:DR
First Name:KIM NHAT
Middle Name:NGUYEN
Last Name:LE-HUYNH
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 1:13792 HOWARD CIR
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3362
Mailing Address - Country:US
Mailing Address - Phone:714-322-7278
Mailing Address - Fax:
Practice Address - Street 1:10130 WARNER AVE STE J
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1619
Practice Address - Country:US
Practice Address - Phone:714-965-5130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13253T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist