Provider Demographics
NPI:1629229497
Name:NGUYEN, TONY NGOC (OD)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:NGOC
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 1:18220 SANTA SOPHIA CIR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5614
Mailing Address - Country:US
Mailing Address - Phone:714-260-1314
Mailing Address - Fax:
Practice Address - Street 1:18000 STUDEBAKER RD STE 505
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2698
Practice Address - Country:US
Practice Address - Phone:562-402-5823
Practice Address - Fax:562-402-5884
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12918T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist