Provider Demographics
NPI:1932741394
Name:VU, DARLINA (RDH)
Entity Type:Individual
Prefix:
First Name:DARLINA
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5002 W MCFADDEN AVE SPC 81
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-1166
Mailing Address - Country:US
Mailing Address - Phone:714-277-7703
Mailing Address - Fax:
Practice Address - Street 1:1835 XIMENO AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2850
Practice Address - Country:US
Practice Address - Phone:562-453-3409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDH33162124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33162Medicaid