Provider Demographics
NPI:1285005660
Name:DOAN, THANH-TRINH (OD)
Entity type:Individual
Prefix:
First Name:THANH-TRINH
Middle Name:
Last Name:DOAN
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 1:1900 NORTHSTAR WAY
Mailing Address - Street 2:APT. 201
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-0936
Mailing Address - Country:US
Mailing Address - Phone:980-253-1573
Mailing Address - Fax:
Practice Address - Street 1:2322 RUTHERFORD RD.
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008
Practice Address - Country:US
Practice Address - Phone:760-444-9682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15435152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist