Provider Demographics
NPI:1619946779
Name:LE, ANH-DAO VU (MD)
Entity Type:Individual
Prefix:DR
First Name:ANH-DAO
Middle Name:VU
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2190 SALTBUSH CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2321
Mailing Address - Country:US
Mailing Address - Phone:714-797-2033
Mailing Address - Fax:714-908-7596
Practice Address - Street 1:13420 NEWPORT AVE STE G
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3745
Practice Address - Country:US
Practice Address - Phone:714-659-6504
Practice Address - Fax:714-908-7596
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81117207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A81117Medicaid
CA00A81117Medicaid