Healthcare Provider Details

I. General information

NPI: 1538296439
Provider Name (Legal Business Name): AMY T VUONG PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14150 CULVER DR 103
IRVINE CA
92604-0315
US

IV. Provider business mailing address

15550 ROCKFIELD BLVD B220
IRVINE CA
92618-2720
US

V. Phone/Fax

Practice location:
  • Phone: 949-857-1888
  • Fax: 949-857-4536
Mailing address:
  • Phone: 949-598-9999
  • Fax: 949-598-9990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT29925
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: