Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A162093 | CA |
NPI | 1003293820 |
---|---|
Provider Name | Dr. Kent Vu |
First Address | Laguna Niguel, CA 92677-6023 |
Second Address | Burbank, CA 91505-4809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 03/06/2020 |