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Organization
QUYEN N. LA O.D., INC
Active
Organization
QUYEN N. LA O.D., INC
Active
Other names
LVC Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MARIE WALKER (LEAD OPTICIAN)
(714) 596-2258
Entity
Organization
Contact information
Practice address
7251 WARNER AVE STE H, HUNTINGTON BEACH, CA 92647-5487
(714) 596-2258
Mailing address
77251 WARNER AVE STE. H, HUNTINGTON BEACH, CA 92647
(714) 596-2258
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12318T
CA
152WC0802X
Corneal and Contact Management Optometrist
12318T
CA
152WP0200X
Pediatric Optometrist
12318T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0123180
—
CA
01
—
WOP12318A
MEDICARE PTAN
CA
Enumeration date
04/10/2015
Last updated
04/10/2015
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