Provider Demographics
NPI:1821684028
Name:TSE, AMY THIEN HUONG (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:THIEN HUONG
Last Name:TSE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18424 SANTANA AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8038
Mailing Address - Country:US
Mailing Address - Phone:714-566-5363
Mailing Address - Fax:
Practice Address - Street 1:101 LAGUNA RD STE C
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3637
Practice Address - Country:US
Practice Address - Phone:714-888-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34735152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist