Provider Demographics
NPI:1295715126
Name:VUONG, REED H (DO)
Entity type:Individual
Prefix:
First Name:REED
Middle Name:H
Last Name:VUONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 TIMBERLAKE WAY
Mailing Address - Street 2:#207
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5412
Mailing Address - Country:US
Mailing Address - Phone:916-691-5855
Mailing Address - Fax:916-691-6066
Practice Address - Street 1:8120 TIMBERLAKE WAY
Practice Address - Street 2:#207
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5412
Practice Address - Country:US
Practice Address - Phone:916-691-5855
Practice Address - Fax:916-691-6066
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A7608OtherSTATE LICENSE
020A76082Medicare ID - Type Unspecified
H61927Medicare UPIN