Provider Demographics
NPI:1649649443
Name:VO, THUY (PA-C)
Entity type:Individual
Prefix:
First Name:THUY
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 BOWCROFT ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-4955
Mailing Address - Country:US
Mailing Address - Phone:619-770-0442
Mailing Address - Fax:
Practice Address - Street 1:5841 BOWCROFT ST
Practice Address - Street 2:UNIT 2
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-4955
Practice Address - Country:US
Practice Address - Phone:619-770-0442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52842363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical