Organization
DR TANYA OPTOMETRY
Active
Other names
Mintz Family Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LETHUY THI NGUYEN O.D. (PRESIDENT)
(909) 985-2876
Entity
Organization
Contact information
Practice address
563 N MOUNTAIN AVE, UPLAND, CA 91786-5016
(909) 985-2876
(909) 946-8585
Mailing address
563 N MOUNTAIN AVE, UPLAND, CA 91786-5016
(909) 985-2876
(909) 946-8585
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
9953
CA
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0099530
—
CA
Enumeration date
01/07/2014
Last updated
03/27/2017
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