Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 13902 | CA |
NPI | 1003043860 |
---|---|
Provider Name | Dr. Thanh-Vi Le Nguyen |
First Address | La Quinta, CA 92253-6516 |
Second Address | La Quinta, CA 92253-6516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 20/11/2012 |