Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | SL5227 | CA |
NPI | 1679609234 |
---|---|
Provider Name | Mr. Hoang Duy Nguyen |
First Address | Westminster, CA 92683-5938 |
Second Address | Westminster, CA 92683-5938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
211494 | EYE MED (01) | |
717PAR | VISION BENEFITS OF AMERIC (01) | PA |