Provider Demographics
NPI:1730295924
Name:VU, PETER HUNG - NGO (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:HUNG - NGO
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9191 WESTMINSTER AVE
Mailing Address - Street 2:STE 106
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-2751
Mailing Address - Country:US
Mailing Address - Phone:714-583-6340
Mailing Address - Fax:714-583-6334
Practice Address - Street 1:9191 WESTMINSTER AVE
Practice Address - Street 2:STE 106
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2751
Practice Address - Country:US
Practice Address - Phone:714-583-6340
Practice Address - Fax:714-583-6334
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68450208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A684500Medicaid
CA00A684500Medicaid