Provider Demographics
NPI:1588704274
Name:VU, BACH LY (DC)
Entity type:Individual
Prefix:DR
First Name:BACH
Middle Name:LY
Last Name:VU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N BREA BLVD
Mailing Address - Street 2:STE G
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3336
Mailing Address - Country:US
Mailing Address - Phone:714-671-1150
Mailing Address - Fax:714-671-0833
Practice Address - Street 1:710 N BREA BLVD
Practice Address - Street 2:STE G
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3336
Practice Address - Country:US
Practice Address - Phone:714-671-1150
Practice Address - Fax:714-671-0833
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor