Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A8596 | CA |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 227955-1 | NY |
NPI | 1063479665 |
---|---|
Provider Name | Dr. Quoc Leduy Vo |
First Address | San Francisco, CA 94117-1022 |
Second Address | San Francisco, CA 94117-1022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 04/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
442 | NMM0OMM CERTIFICATE NUMBE (01) | |
BV8342444 | DEA NUMBER (01) | |
H89150 | (02) | CA |