Individual
DR. HOA PHUONG NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7155 BROADWAY, LEMON GROVE, CA 91945-1408
(619) 315-0192
Mailing address
7155 BROADWAY, LEMON GROVE, CA 91945-1408
(619) 315-0192
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 12630T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BB516Z
MEDICARE PTAN
—
Enumeration date
06/26/2006
Last updated
03/27/2024
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