Organization
PHAM-VANG OPTOMETRY LLC
Active
Other names
Eye Doc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDY PHAM-VANG OD (CEO)
(763) 316-4193
Entity
Organization
Contact information
Practice address
7074 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429-1370
(763) 639-0103
Mailing address
7074 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429-1370
(763) 639-0103
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
3056
MN
332B00000X
Durable Medical Equipment & Medical Supplies
3056
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
635140001
—
MN
Enumeration date
05/27/2016
Last updated
05/27/2016
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