Provider Demographics
NPI:1538522669
Name:VU, PRISCILLA QUYNH-PHUONG (MD)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:QUYNH-PHUONG
Last Name:VU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3553 WHIPPLE RD BLDG B1
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-1507
Mailing Address - Country:US
Mailing Address - Phone:510-675-2020
Mailing Address - Fax:
Practice Address - Street 1:3553 WHIPPLE RD BLDG B1
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1507
Practice Address - Country:US
Practice Address - Phone:510-675-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA151403207W00000X, 207WX0120X
PAMD473782207W00000X, 207WX0120X
390200000X
ORMD197579207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program