Provider Demographics
NPI:1326685322
Name:VUONG, CA
Entity Type:Individual
Prefix:
First Name:CA
Middle Name:
Last Name:VUONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5538 SHOREVIEW DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-2226
Mailing Address - Country:US
Mailing Address - Phone:310-408-9839
Mailing Address - Fax:
Practice Address - Street 1:609 DEEP VALLEY DR STE 200
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3614
Practice Address - Country:US
Practice Address - Phone:310-896-2316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver