Provider Demographics
NPI:1609118041
Name:VO MEDICAL CENTER
Entity Type:Organization
Organization Name:VO MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIEN
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-352-2551
Mailing Address - Street 1:1590 S IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4241
Mailing Address - Country:US
Mailing Address - Phone:760-352-2551
Mailing Address - Fax:888-631-5150
Practice Address - Street 1:1590 S IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4241
Practice Address - Country:US
Practice Address - Phone:760-352-2551
Practice Address - Fax:888-631-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111104208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty