Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | OP61258983 | WA |
NPI | 1134583719 |
---|---|
Provider Name | Christine Vuong |
First Address | Ontario, CA 91761-7925 |
Second Address | Ontario, CA 91761-7925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2016 |
Last Update Date | 05/02/2022 |