Provider Demographics
NPI:1790805455
Name:NGUYEN, DAVID DZUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DZUNG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11282 BARCLAY DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-1757
Mailing Address - Country:US
Mailing Address - Phone:714-839-4584
Mailing Address - Fax:714-379-5497
Practice Address - Street 1:6731 WESTMINSTER BLVD STE 102
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3792
Practice Address - Country:US
Practice Address - Phone:714-379-5495
Practice Address - Fax:714-379-5497
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9951T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist