Provider Demographics
NPI:1538123823
Name:VU, PHONG QUOC (MD)
Entity Type:Individual
Prefix:DR
First Name:PHONG
Middle Name:QUOC
Last Name:VU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14541 BROOKHURST ST
Mailing Address - Street 2:SUITE D2
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5700
Mailing Address - Country:US
Mailing Address - Phone:714-531-6651
Mailing Address - Fax:714-531-5835
Practice Address - Street 1:14541 BROOKHURST ST
Practice Address - Street 2:SUITE D2
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5700
Practice Address - Country:US
Practice Address - Phone:714-531-6651
Practice Address - Fax:714-531-5835
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2011-02-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA85129Medicare UPIN