Individual
PHUONG LE AI DUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTOMETRIST (O.D.)
Contact information
Practice address
1811 HILLSDALE AVE, SAN JOSE, CA 95124-3027
(408) 269-1267
(408) 269-1265
Mailing address
630 BLOSSOM HILL RD STE 20, SAN JOSE, CA 95123-3056
(408) 300-0717
(888) 604-2519
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
CA 12716 T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12716
LICENSE NUMBER
CA
Enumeration date
08/18/2006
Last updated
07/21/2022
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