Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A152512 | CA |
NPI | 1003279068 |
---|---|
Provider Name | Ms. Van T Vu |
First Address | Oakland, CA 94606-1716 |
Second Address | Oakland, CA 94606-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2016 |
Last Update Date | 12/09/2019 |