Provider Demographics
NPI:1699241182
Name:MORGAN HILL EYECARE OPTOMETRY
Entity type:Organization
Organization Name:MORGAN HILL EYECARE OPTOMETRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THANH-SON
Authorized Official - Middle Name:QUANG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-807-0553
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:
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:408-807-0553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THANH-SON NGUYEN OPTOMETRIST DBA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-23
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1588069371OtherNPI