Provider Demographics
NPI:1609235043
Name:HUA, NANCY-NGHI LE (OD)
Entity Type:Individual
Prefix:DR
First Name:NANCY-NGHI
Middle Name:LE
Last Name:HUA
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 1:4423 REDONDO BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-3465
Mailing Address - Country:US
Mailing Address - Phone:408-480-4537
Mailing Address - Fax:310-793-7133
Practice Address - Street 1:4423 REDONDO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-3465
Practice Address - Country:US
Practice Address - Phone:408-480-4537
Practice Address - Fax:310-793-7133
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33346152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33346OtherSTATE BOARD OF OPTOMETRY