Provider Demographics
NPI:1831237569
Name:NHAN, HANG T (OD)
Entity type:Individual
Prefix:DR
First Name:HANG
Middle Name:T
Last Name:NHAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 CERNON ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4502
Mailing Address - Country:US
Mailing Address - Phone:707-446-2090
Mailing Address - Fax:707-446-4405
Practice Address - Street 1:340 CERNON ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4502
Practice Address - Country:US
Practice Address - Phone:707-446-2090
Practice Address - Fax:707-446-4405
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11196T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0111960Medicaid