Provider Demographics
NPI:1912920471
Name:VU, DAVID BAO (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BAO
Last Name:VU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 MAGNOLIA AVE STE C4
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3119
Mailing Address - Country:US
Mailing Address - Phone:951-817-9400
Mailing Address - Fax:951-371-5583
Practice Address - Street 1:720 MAGNOLIA AVE STE C4
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3119
Practice Address - Country:US
Practice Address - Phone:951-817-9400
Practice Address - Fax:951-817-9404
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC296510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV05407Medicare UPIN
CADC0296510Medicare ID - Type UnspecifiedDAVID VU MEMBER ID
CAZZZ01921ZMedicare ID - Type UnspecifiedGROUP ID FOR BETTER BODY