Provider Demographics
NPI:1942616040
Name:DANG, VIRGINIE (OD)
Entity Type:Individual
Prefix:
First Name:VIRGINIE
Middle Name:
Last Name:DANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5300 LENNOX AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1662
Mailing Address - Country:US
Mailing Address - Phone:661-869-2010
Mailing Address - Fax:661-869-2708
Practice Address - Street 1:5300 LENNOX AVE STE 101
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1662
Practice Address - Country:US
Practice Address - Phone:661-869-2010
Practice Address - Fax:661-869-2708
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA14915152W00000X, 152WP0200X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy