Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 14062 | CA |
NPI | 1013223510 |
---|---|
Provider Name | Nancy Nguyen |
First Address | Sacramento, CA 95816-7318 |
Second Address | Berkeley, CA 94720-2020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2010 |
Last Update Date | 23/08/2010 |