Provider Demographics
NPI:1821635335
Name:NGUYEN FAMILY VISION CARE OPTOMETRY CORPORATION
Entity Type:Organization
Organization Name:NGUYEN FAMILY VISION CARE OPTOMETRY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRANG
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-449-0066
Mailing Address - Street 1:2901 WILSHIRE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4915
Mailing Address - Country:US
Mailing Address - Phone:310-449-0066
Mailing Address - Fax:310-453-2971
Practice Address - Street 1:2901 WILSHIRE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4915
Practice Address - Country:US
Practice Address - Phone:310-449-0066
Practice Address - Fax:310-453-2971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty