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Organization
WALNUT CREEK OPTOMETRY GROUP
Active
Organization
WALNUT CREEK OPTOMETRY GROUP
Active
Other names
walnut creek optometry group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BACH-KIM NGUYEN O.D. (OPTOMETRIST /OWNER)
(925) 934-4313
Entity
Organization
Contact information
Practice address
1844 SAN MIGUEL DR, SUITE 312, WALNUT CREEK, CA 94596-4963
(925) 934-4313
(925) 943-1907
Mailing address
1844 SAN MIGUEL DR, SUITE 312, WALNUT CREEK, CA 94596-4963
(925) 934-4313
(925) 943-1907
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10544T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG894A
PROVIDER TRANSACTION ACCESS NUMBER (PTAN), VALLEJO LOCATION
CA
01
—
SD0105440
PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
CA
Enumeration date
11/03/2006
Last updated
10/26/2023
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