Provider Demographics
NPI:1790187771
Name:VU, SON TRUONG (DPT)
Entity Type:Individual
Prefix:DR
First Name:SON
Middle Name:TRUONG
Last Name:VU
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 E CAPITOL EXPY # 713
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-2415
Mailing Address - Country:US
Mailing Address - Phone:408-499-4593
Mailing Address - Fax:
Practice Address - Street 1:1101 STROUD AVE
Practice Address - Street 2:
Practice Address - City:KINGSBURG
Practice Address - State:CA
Practice Address - Zip Code:93631-1016
Practice Address - Country:US
Practice Address - Phone:559-897-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41674225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist