Provider Demographics
NPI:1598817082
Name:HUYNH, BAN HAN (OD)
Entity Type:Individual
Prefix:
First Name:BAN
Middle Name:HAN
Last Name:HUYNH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 MCLAUGHLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2612
Mailing Address - Country:US
Mailing Address - Phone:408-286-2008
Mailing Address - Fax:
Practice Address - Street 1:971 MCLAUGHLIN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2612
Practice Address - Country:US
Practice Address - Phone:408-286-2008
Practice Address - Fax:408-286-2009
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13120152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist