Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 44554 | CA |
NPI | 1003942384 |
---|---|
Provider Name | Anh Thi Tuyet Vu |
First Address | Fountain Valley, CA 92708-1043 |
Second Address | Santa Ana, CA 92706-3929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 08/07/2007 |