Provider Demographics
NPI:1528149747
Name:DUONG, NATALIE DO (OD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:DO
Last Name:DUONG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:NATALIE
Other - Middle Name:KHUE
Other - Last Name:DO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2378 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5101
Mailing Address - Country:US
Mailing Address - Phone:714-635-6680
Mailing Address - Fax:
Practice Address - Street 1:2378 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5101
Practice Address - Country:US
Practice Address - Phone:714-635-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11875152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU90999Medicare UPIN
OP11875Medicare ID - Type Unspecified