Provider Demographics
NPI:1023161759
Name:NGUYEN, VU ANH TRINH (OD)
Entity type:Individual
Prefix:
First Name:VU
Middle Name:ANH TRINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15949 AVENAL CT
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-7885
Mailing Address - Country:US
Mailing Address - Phone:626-602-5567
Mailing Address - Fax:
Practice Address - Street 1:24201 VALENCIA BLVD
Practice Address - Street 2:VALENCIA TOWN CENTER
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1861
Practice Address - Country:US
Practice Address - Phone:661-287-9893
Practice Address - Fax:661-287-3831
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13134T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist