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Organization
PACIFIC OPTOMETRY VISION, INC.
Active
Organization
PACIFIC OPTOMETRY VISION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHONG QUOC NGUYEN O.D. (PRESIDENT)
(626) 810-4535
Entity
Organization
Contact information
Practice address
2402 S AZUSA AVE, WEST COVINA, CA 91792-1512
(626) 810-4535
(626) 810-7371
Mailing address
2402 S AZUSA AVE, WEST COVINA, CA 91792-1512
(626) 810-4535
(626) 810-7371
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11932T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6268104535
VSP
CA
05
—
SD0119320
—
CA
Enumeration date
05/22/2008
Last updated
11/25/2009
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