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Organization
PROSPECTIVE VISION OPTOMETRIC CORP
Active
Organization
PROSPECTIVE VISION OPTOMETRIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNY NGUYEN OD (PRESIDENT)
(562) 377-0941
Entity
Organization
Contact information
Practice address
7250 CARSON BLVD, LONG BEACH, CA 90808-2358
(562) 377-0941
(562) 330-2687
Mailing address
7250 CARSON BLVD, LONG BEACH, CA 90808-2358
(562) 377-0941
(562) 330-2687
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB319343
MEDICARE
CA
Enumeration date
05/28/2021
Last updated
06/30/2023
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