Provider Demographics
NPI:1568617611
Name:NGUYEN, HONG C (OD)
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:C
Last Name:NGUYEN
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 1:925 BLOSSOM HILL RD
Mailing Address - Street 2:OAKRIDGE MALL #1451
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1230
Mailing Address - Country:US
Mailing Address - Phone:408-284-0140
Mailing Address - Fax:
Practice Address - Street 1:925 BLOSSOM HILL RD
Practice Address - Street 2:OAKRIDGE MALL #1451
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1230
Practice Address - Country:US
Practice Address - Phone:408-284-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13543152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist