Provider Demographics
NPI:1215421367
Name:DUONG, ISABEL (OD)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:DUONG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 PROVON LN APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-2742
Mailing Address - Country:US
Mailing Address - Phone:425-208-6094
Mailing Address - Fax:
Practice Address - Street 1:23600 TELO AVE STE 100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4036
Practice Address - Country:US
Practice Address - Phone:310-543-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33977152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist