Provider Demographics
NPI:1609206101
Name:VU, VICKI (OD)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9842 BOLSA AVE
Mailing Address - Street 2:STE. 104
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6680
Mailing Address - Country:US
Mailing Address - Phone:714-775-3237
Mailing Address - Fax:
Practice Address - Street 1:9842 BOLSA AVE
Practice Address - Street 2:STE. 104
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6680
Practice Address - Country:US
Practice Address - Phone:714-775-3237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2016-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14719152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist