Provider Demographics
NPI:1023340221
Name:CHAN P VO, MD
Entity type:Organization
Organization Name:CHAN P VO, MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-OTOLARYNGOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-894-9192
Mailing Address - Street 1:2900 LEMAY FERRY RD
Mailing Address - Street 2:#214
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125
Mailing Address - Country:US
Mailing Address - Phone:314-894-9192
Mailing Address - Fax:314-894-3210
Practice Address - Street 1:2900 LEMAY FERRY RD
Practice Address - Street 2:#214
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125
Practice Address - Country:US
Practice Address - Phone:314-894-9192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHAN P VO, M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2672237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty