Provider Demographics
NPI:1255352431
Name:THUAN H VO MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:THUAN H VO MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THUAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-899-2911
Mailing Address - Street 1:9024 BOLSA AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5531
Mailing Address - Country:US
Mailing Address - Phone:714-899-2911
Mailing Address - Fax:714-899-2150
Practice Address - Street 1:9024 BOLSA AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5531
Practice Address - Country:US
Practice Address - Phone:714-899-2911
Practice Address - Fax:714-899-2150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63971207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A639710Medicaid
CAWA63971MMedicare ID - Type UnspecifiedPPIN
CA00A639710Medicaid
CAW16996Medicare ID - Type UnspecifiedGROUP ID