Provider Demographics
NPI:1912260878
Name:NGUYEN, CATHY LINH (OD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:LINH
Last Name:NGUYEN
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 1:8190 MANGO AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-3610
Mailing Address - Country:US
Mailing Address - Phone:909-350-2020
Mailing Address - Fax:909-350-2341
Practice Address - Street 1:8190 MANGO AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3610
Practice Address - Country:US
Practice Address - Phone:909-350-2020
Practice Address - Fax:909-350-2341
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14390152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist