Provider Demographics
NPI:1316011703
Name:VO, TRIEU LONG (DPM)
Entity Type:Individual
Prefix:DR
First Name:TRIEU
Middle Name:LONG
Last Name:VO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14124 FOOTHILL BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:818-367-1012
Mailing Address - Fax:818-302-3500
Practice Address - Street 1:14124 FOOTHILL BLVD
Practice Address - Street 2:STE 100
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-367-1012
Practice Address - Fax:818-302-3500
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4039213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00148920OtherMEDICARE RAILROAD
CA000E40390Medicaid
U64813Medicare UPIN
CAE4039BMedicare PIN
CAE4039CMedicare PIN
CAE4039EMedicare PIN