Provider Demographics
NPI:1679609234
Name:NGUYEN, HOANG DUY
Entity Type:Individual
Prefix:MR
First Name:HOANG
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9371 KRAMER AVE
Mailing Address - Street 2:STE. F
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5938
Mailing Address - Country:US
Mailing Address - Phone:714-897-9474
Mailing Address - Fax:714-897-7434
Practice Address - Street 1:9371 KRAMER AVE
Practice Address - Street 2:STE. F
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5938
Practice Address - Country:US
Practice Address - Phone:714-897-9474
Practice Address - Fax:714-897-7434
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL5227156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
Provider Identifiers
StateIdentifier IDID TypeIssuer
211494OtherEYE MED
PA717PAROtherVISION BENEFITS OF AMERIC