Provider Demographics
NPI:1992077978
Name:VO GROUP
Entity type:Organization
Organization Name:VO GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUANG
Authorized Official - Middle Name:
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-759-8600
Mailing Address - Street 1:120 TUSTIN AVE
Mailing Address - Street 2:1002
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4729
Mailing Address - Country:US
Mailing Address - Phone:949-759-8600
Mailing Address - Fax:714-492-8213
Practice Address - Street 1:120 TUSTIN AVE
Practice Address - Street 2:1002
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4729
Practice Address - Country:US
Practice Address - Phone:949-759-8600
Practice Address - Fax:714-492-8213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97959208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGA923AMedicare PIN