Provider Demographics
NPI:1689805830
Name:DO, NHAN T (OD)
Entity Type:Individual
Prefix:DR
First Name:NHAN
Middle Name:T
Last Name:DO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:NATHAN
Other - Middle Name:T
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:3750 W MCFADDEN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-1388
Mailing Address - Country:US
Mailing Address - Phone:714-839-1515
Mailing Address - Fax:
Practice Address - Street 1:3750 W MCFADDEN AVE STE C
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-1388
Practice Address - Country:US
Practice Address - Phone:714-839-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10310T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist