Healthcare Provider Details

I. General information

NPI: 1205852183
Provider Name (Legal Business Name): MATTHEW VO M D INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 LINDEN AVE
LONG BEACH CA
90813-3321
US

IV. Provider business mailing address

PO BOX 4259
CERRITOS CA
90703-4259
US

V. Phone/Fax

Practice location:
  • Phone: 562-491-9000
  • Fax:
Mailing address:
  • Phone: 562-407-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA68449
License Number StateCA

VIII. Authorized Official

Name: DR. MATTHEW VO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 562-519-4321