Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 34472TLG | CA |
NPI | 1003454604 |
---|---|
Provider Name | Loan Yen Huynh |
First Address | San Diego, CA 92128-3202 |
Second Address | San Diego, CA 92120-2705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2019 |
Last Update Date | 13/12/2019 |