Healthcare Provider Details

I. General information

NPI: 1730113242
Provider Name (Legal Business Name): DINH QUOC VU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N BRANDON RD SUITE D
FALLBROOK CA
92028-2253
US

IV. Provider business mailing address

3307 MENDENARO CT
FALLBROOK CA
92028-8041
US

V. Phone/Fax

Practice location:
  • Phone: 760-728-4561
  • Fax:
Mailing address:
  • Phone: 760-723-5514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG69276
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: