Provider Demographics
NPI:1588069371
Name:NGUYEN, THANH-SON Q (OD)
Entity type:Individual
Prefix:DR
First Name:THANH-SON
Middle Name:Q
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:SON
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:16985 MONTEREY RD STE 318
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5131
Mailing Address - Country:US
Mailing Address - Phone:408-612-4462
Mailing Address - Fax:669-888-3409
Practice Address - Street 1:16985 MONTEREY RD STE 318
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5131
Practice Address - Country:US
Practice Address - Phone:408-612-4462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15142152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist