Provider Demographics
NPI:1811368897
Name:VU, BAO-KHUE THUY (PA-C)
Entity Type:Individual
Prefix:
First Name:BAO-KHUE
Middle Name:THUY
Last Name:VU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KHUE
Other - Middle Name:
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:7955 WESTMINSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4001
Mailing Address - Country:US
Mailing Address - Phone:714-379-3221
Mailing Address - Fax:
Practice Address - Street 1:7955 WESTMINSTER BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4001
Practice Address - Country:US
Practice Address - Phone:714-379-3221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical