Provider Demographics
NPI:1659642502
Name:LUONG, VANGIE (PA-C)
Entity Type:Individual
Prefix:
First Name:VANGIE
Middle Name:
Last Name:LUONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:909 S FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2625
Mailing Address - Country:US
Mailing Address - Phone:626-389-9300
Mailing Address - Fax:626-389-9336
Practice Address - Street 1:909 S FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2625
Practice Address - Country:US
Practice Address - Phone:626-389-9300
Practice Address - Fax:626-389-9336
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2018-02-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant