Provider Demographics
NPI:1023152766
Name:NGUYEN, HOWARD HAI TUAN (OD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:HAI TUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12345 MOUNTAIN AVE STE X
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2783
Mailing Address - Country:US
Mailing Address - Phone:909-548-0300
Mailing Address - Fax:909-548-0309
Practice Address - Street 1:12345 MOUNTAIN AVE STE X
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2783
Practice Address - Country:US
Practice Address - Phone:909-548-0300
Practice Address - Fax:909-548-0309
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13181TGL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist