Healthcare Provider Details

I. General information

NPI: 1396967337
Provider Name (Legal Business Name): YVONNE VU BACH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVONNE HA VU M.D.

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 12/21/2021
Certification Date: 12/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12100 EUCLID ST
GARDEN GROVE CA
92840-3304
US

IV. Provider business mailing address

12100 EUCLID ST
GARDEN GROVE CA
92840-3304
US

V. Phone/Fax

Practice location:
  • Phone: 714-741-3448
  • Fax: 714-741-3505
Mailing address:
  • Phone: 714-741-3448
  • Fax: 714-741-3505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA95383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: