Provider Demographics
NPI:1366434748
Name:VO, THUAN H (MD)
Entity type:Individual
Prefix:
First Name:THUAN
Middle Name:H
Last Name:VO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9024 BOLSA AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5531
Mailing Address - Country:US
Mailing Address - Phone:714-899-2911
Mailing Address - Fax:714-899-2150
Practice Address - Street 1:9024 BOLSA AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5531
Practice Address - Country:US
Practice Address - Phone:714-899-2911
Practice Address - Fax:714-899-2150
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-09
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
CAA63971207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA63971MOtherMEDICARE PPIN
CA00A639710OtherMEDI-CAL PROVIDER NUMBER
W16996OtherMEDICARE GROUP ID
W16996OtherMEDICARE GROUP ID