Provider Demographics
NPI:1306132063
Name:DOAN, HIEU (OD)
Entity type:Individual
Prefix:
First Name:HIEU
Middle Name:
Last Name:DOAN
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 1:4210 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-2742
Mailing Address - Country:US
Mailing Address - Phone:909-425-2407
Mailing Address - Fax:909-663-9074
Practice Address - Street 1:4210 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-2742
Practice Address - Country:US
Practice Address - Phone:909-425-2407
Practice Address - Fax:909-663-9074
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14158152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist