1083828271 NPI number — LYNH HOANG NGUYEN O.D., PC

Table of content: (NPI 1083828271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083828271 NPI number — LYNH HOANG NGUYEN O.D., PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LYNH HOANG NGUYEN O.D., PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VEGAS EYE CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083828271
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9484 BREWING CLOUD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89148-4244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8020 S RAINBOW BLVD
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89139-6483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-658-3937
Provider Business Practice Location Address Fax Number:
702-869-3937
Provider Enumeration Date:
05/09/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
LYNH
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
702-259-4283

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  531 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)