Provider Demographics
NPI:1992157887
Name:VU, MONICA (OD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40700 CALIFORNIA OAKS RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5789
Mailing Address - Country:US
Mailing Address - Phone:1951-696-1135
Mailing Address - Fax:951-698-8621
Practice Address - Street 1:40700 CALIFORNIA OAKS RD STE 106
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5789
Practice Address - Country:US
Practice Address - Phone:195-169-6113
Practice Address - Fax:951-696-1135
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAOPT33556TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12490OtherSTATEMENT OF LICENSURE
CAOPT33556TLGOtherCALIFORNIA STATE OPTOMETRY LICENSE