Provider Demographics
NPI:1184014755
Name:DR. BRYANT VO AN OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:DR. BRYANT VO AN OPTOMETRIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-786-7888
Mailing Address - Street 1:5327 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2938
Mailing Address - Country:US
Mailing Address - Phone:949-786-7888
Mailing Address - Fax:949-786-1817
Practice Address - Street 1:5327 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2938
Practice Address - Country:US
Practice Address - Phone:949-786-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13286TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty