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Organization

V. T. LY OD INC

Active
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Organization

V. T. LY OD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VAN T. LY OD (OPTOMETRIST)
(714) 839-2021
Entity
Organization

Contact information

Practice address
16341 HARBOR BLVD, FOUNTAIN VALLEY, CA 92708-1311
(714) 839-2021
(714) 839-3918
Mailing address
16341 HARBOR BLVD, FOUNTAIN VALLEY, CA 92708-1311
(714) 839-2021
(714) 839-3918

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10370T
CA
152WC0802X
Corneal and Contact Management Optometrist
10370T
CA
152WL0500X
Low Vision Rehabilitation Optometrist
10370T
CA

Other

Enumeration date
08/08/2007
Last updated
08/08/2007
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