Provider Demographics
NPI:1902895451
Name:LE, TUONG-VI HOANG (DOCTOR OF OPTOMETRY)
Entity Type:Individual
Prefix:DR
First Name:TUONG-VI
Middle Name:HOANG
Last Name:LE
Suffix:
Gender:F
Credentials:DOCTOR OF OPTOMETRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 INTERNATIONAL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-2912
Mailing Address - Country:US
Mailing Address - Phone:510-832-0908
Mailing Address - Fax:510-832-0907
Practice Address - Street 1:600 INTERNATIONAL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-2912
Practice Address - Country:US
Practice Address - Phone:510-832-0908
Practice Address - Fax:510-832-0907
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12323T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0123230Medicaid
SD0123230Medicare PIN
CASD0123230Medicaid