Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 100573 | CA |
NPI | 1063967966 |
---|---|
Provider Name | Dr. Giao Vu |
First Address | Berkeley, CA 94709-2029 |
Second Address | Oakland, CA 94602-1018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2016 |
Last Update Date | 20/08/2016 |