Provider Demographics
NPI:1518763796
Name:DR. QUAN & ASSOCIATES OPTOMETRIC CORP
Entity type:Organization
Organization Name:DR. QUAN & ASSOCIATES OPTOMETRIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUAN
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:951-454-9782
Mailing Address - Street 1:23291 SAND CANYON CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-5085
Mailing Address - Country:US
Mailing Address - Phone:951-454-9782
Mailing Address - Fax:
Practice Address - Street 1:1800 N PERRIS BLVD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-2701
Practice Address - Country:US
Practice Address - Phone:951-561-0137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty