Provider Demographics
NPI:1376878579
Name:VU, TRAMANH THI (PA-C)
Entity Type:Individual
Prefix:
First Name:TRAMANH
Middle Name:THI
Last Name:VU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11160 WARNER AVE
Mailing Address - Street 2:SUITE 421
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4008
Mailing Address - Country:US
Mailing Address - Phone:714-966-2009
Mailing Address - Fax:714-966-2372
Practice Address - Street 1:11160 WARNER AVE
Practice Address - Street 2:SUITE 421
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4008
Practice Address - Country:US
Practice Address - Phone:714-966-2009
Practice Address - Fax:714-966-2372
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19804363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant