MEDICARE: VO GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	A97959	CA

General Provider Information

NPI Number	:	1992077978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VO GROUP

Provider Business Mailing Address
First Line	:	120 TUSTIN AVE
Second Line	:	1002
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4729
Country	:	US
Telephone Number	:	949-759-8600
Fax Number	:	714-492-8213

Provider Business Practice Location Address
First Line	:	120 TUSTIN AVE
Second Line	:	1002
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4729
Country	:	US
Telephone Number	:	949-759-8600
Fax Number	:	714-492-8213

Authorized Official
Title or Position	:	PRESIDENT
Name	:	QUANG VO
Credential	:	MD
Telephone Number	:	949-759-8600

Provider Enumeration Date	:	02/06/2012
Last Update Date	:	05/13/2015

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