Provider Demographics
NPI:1386992543
Name:JULIA NHUNG PHAN YEUNG, O.D., PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JULIA NHUNG PHAN YEUNG, O.D., PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:PHAN YEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-878-8227
Mailing Address - Street 1:17191 BLACK WALNUT CT
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886
Mailing Address - Country:US
Mailing Address - Phone:714-878-8227
Mailing Address - Fax:562-697-9330
Practice Address - Street 1:1340 S. BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631
Practice Address - Country:US
Practice Address - Phone:562-697-9223
Practice Address - Fax:562-697-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-20
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty