Provider Demographics
NPI:1831967637
Name:HUYNH FAMILY PROFESSIONAL OPTOMETRY CORP.
Entity type:Organization
Organization Name:HUYNH FAMILY PROFESSIONAL OPTOMETRY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRINH
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-282-5420
Mailing Address - Street 1:1835 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-2403
Mailing Address - Country:US
Mailing Address - Phone:510-282-5420
Mailing Address - Fax:
Practice Address - Street 1:1919 DAVIS ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-1231
Practice Address - Country:US
Practice Address - Phone:510-430-9903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty