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Organization
VALLEJO OPTOMETRY GROUP
Active
Organization
VALLEJO OPTOMETRY GROUP
Active
Parent organization
WALNUT CREEK OPTOMETRY GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALNUT CREEK OPTOMETRY GROUP
Authorized official
DR. BACH-KIM NGUYEN O.D. (OWNER)
(707) 554-1773
Entity
Organization
Contact information
Practice address
2103 REDWOOD ST, SUITE 100, VALLEJO, CA 94590-3608
(707) 554-1773
(707) 554-1782
Mailing address
2103 REDWOOD ST, SUITE 100, VALLEJO, CA 94590-3608
(707) 554-1773
(707) 554-1782
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10544
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ00757Z
MEDICARE GROUP NUMBER
CA
Enumeration date
01/30/2007
Last updated
10/26/2023
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