Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25183 | AZ |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 25183 | AZ |
NPI | 1184605859 |
---|---|
Provider Name | Louis Pak-Shun Vu |
First Address | Glendale, AZ 85306-4706 |
Second Address | Glendale, AZ 85306-4706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 09/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
464467 | (02) | AZ |
704321 | (05) | AZ |
704326 | (05) | AZ |