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Organization

MELODY TAM NGUYEN OD INC

Active
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Organization

MELODY TAM NGUYEN OD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELODY TAM NGUYEN O.D. (PRESIDENT)
(714) 892-4171
Entity
Organization

Contact information

Practice address
9191 BOLSA AVE STE 116, WESTMINSTER, CA 92683-5502
(714) 892-4171
(714) 891-3886
Mailing address
9191 BOLSA AVE STE 116, WESTMINSTER, CA 92683-5502
(714) 892-4171
(714) 891-3886

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 11086 TPA
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB853A
MEDICARE PTAN
CA
05
—
SD 0110861
—
CA
Enumeration date
11/26/2008
Last updated
12/26/2018
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