Provider Demographics
NPI:1972039188
Name:DIEU NGA TRUONG & TRA MI TRUONG OPTOMETRY INC
Entity Type:Organization
Organization Name:DIEU NGA TRUONG & TRA MI TRUONG OPTOMETRY INC
Other - Org Name:ISTYLE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:TRA MI
Authorized Official - Middle Name:THI
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-507-8222
Mailing Address - Street 1:9430 WARNER AVE STE M
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-2826
Mailing Address - Country:US
Mailing Address - Phone:714-377-2020
Mailing Address - Fax:714-377-2021
Practice Address - Street 1:9430 WARNER AVE STE M
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2826
Practice Address - Country:US
Practice Address - Phone:714-377-2020
Practice Address - Fax:714-377-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9962T152W00000X
CA10459T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty