Healthcare Provider Details

I. General information

NPI: 1790454387
Provider Name (Legal Business Name): AN M VO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 06/26/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEMORIALCARE MEDICAL GROUP 11420 WARNER AVE.
FOUNTAIN VALLEY CA
92708
US

IV. Provider business mailing address

MEMORIALCARE MEDICAL GROUP 11420 WARNER AVE.
FOUNTAIN VALLEY CA
92708
US

V. Phone/Fax

Practice location:
  • Phone: 714-549-1300
  • Fax: 714-433-3100
Mailing address:
  • Phone: 714-549-1300
  • Fax: 714-433-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: