Provider Demographics
NPI:1790970812
Name:VO, BRYANT (OD)
Entity Type:Individual
Prefix:DR
First Name:BRYANT
Middle Name:
Last Name:VO
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 1:5327 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2938
Mailing Address - Country:US
Mailing Address - Phone:949-786-7888
Mailing Address - Fax:
Practice Address - Street 1:5327 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2938
Practice Address - Country:US
Practice Address - Phone:949-786-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13286152W00000X
CA13286T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management