Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | NP 19800 | CA |
NPI | 1003101726 |
---|---|
Provider Name | Vivien Chan Trieu |
First Address | Alhambra, CA 91803-2920 |
Second Address | Alhambra, CA 91803-2920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2011 |
Last Update Date | 10/06/2011 |