Healthcare Provider Details

I. General information

NPI: 1760496574
Provider Name (Legal Business Name): THUONG D VO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44215 15TH ST W #203
LANCASTER CA
93534-4014
US

IV. Provider business mailing address

24707 RAILROAD AVE
SANTA CLARITA CA
91321-1711
US

V. Phone/Fax

Practice location:
  • Phone: 661-948-0062
  • Fax:
Mailing address:
  • Phone: 661-379-8085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA104152
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA104152
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: