Provider Demographics
NPI:1679948467
Name:TRINH FAMILY OPTOMETRIC CORPORATION
Entity Type:Organization
Organization Name:TRINH FAMILY OPTOMETRIC CORPORATION
Other - Org Name:EYE PLACE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THANH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-730-5964
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-06
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13784152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty