Provider Demographics
NPI:1649409996
Name:TRINH, THANH TU I (OD)
Entity Type:Individual
Prefix:
First Name:THANH
Middle Name:TU
Last Name:TRINH
Suffix:I
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 1:7119 ELK GROVE BLVD
Mailing Address - Street 2:SUITE 123
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-9568
Mailing Address - Country:US
Mailing Address - Phone:916-683-5670
Mailing Address - Fax:
Practice Address - Street 1:7119 ELK GROVE BLVD
Practice Address - Street 2:SUITE 123
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-9568
Practice Address - Country:US
Practice Address - Phone:916-683-5670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13784152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist