Provider Demographics
NPI:1821181710
Name:VU, SUZANNE MARIE (DC)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:MARIE
Last Name:VU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5604 BALBOA AVE
Mailing Address - Street 2:STE. 106
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2700
Mailing Address - Country:US
Mailing Address - Phone:858-492-1000
Mailing Address - Fax:858-492-1077
Practice Address - Street 1:5604 BALBOA AVE
Practice Address - Street 2:STE. 106
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2700
Practice Address - Country:US
Practice Address - Phone:858-492-1000
Practice Address - Fax:858-492-1077
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 27216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor