Provider Demographics
NPI:1801829320
Name:VINCENT, THO NUONG (MD)
Entity Type:Individual
Prefix:DR
First Name:THO
Middle Name:NUONG
Last Name:VINCENT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 809
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-585-9335
Mailing Address - Fax:949-585-9876
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 809
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-585-9335
Practice Address - Fax:949-585-9876
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2021-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA52589207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52589OtherLINCENSE
CAW12250Medicare UPIN