Provider Demographics
NPI:1760634778
Name:VU, KEVIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:A
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6830 STOCKTON BLVD STE 155
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2392
Mailing Address - Country:US
Mailing Address - Phone:916-476-3008
Mailing Address - Fax:855-291-3367
Practice Address - Street 1:6830 STOCKTON BLVD STE 155
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2392
Practice Address - Country:US
Practice Address - Phone:916-476-3008
Practice Address - Fax:855-291-3367
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105487208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine