Provider Demographics
NPI: | 1649595240 |
---|---|
Name: | TUEN-BEHM, VICTORIA CHING-YUM (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | VICTORIA |
Middle Name: | CHING-YUM |
Last Name: | TUEN-BEHM |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | VICTORIA |
Other - Middle Name: | CHING-YUM |
Other - Last Name: | TUEN |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | MD |
Mailing Address - Street 1: | 200 1ST ST SW |
Mailing Address - Street 2: | |
Mailing Address - City: | ROCHESTER |
Mailing Address - State: | MN |
Mailing Address - Zip Code: | 55905-0001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 507-284-2511 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 200 1ST ST SW |
Practice Address - Street 2: | |
Practice Address - City: | ROCHESTER |
Practice Address - State: | MN |
Practice Address - Zip Code: | 55905-0001 |
Practice Address - Country: | US |
Practice Address - Phone: | 507-284-2511 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2010-04-07 |
Last Update Date: | 2020-08-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MN | 54626 | 208000000X, 208000000X |
MN | 105702 | 208000000X |
MN | 390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MN | 370004483 | Medicare PIN |