Healthcare Provider Details

I. General information

NPI: 1295750974
Provider Name (Legal Business Name): LINDA VU MD, A MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 04/16/2020
Certification Date: 04/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 E GARVEY AVE SUITE 201
MONTEREY PARK CA
91755-1974
US

IV. Provider business mailing address

PO BOX 3328
SEAL BEACH CA
90740-2328
US

V. Phone/Fax

Practice location:
  • Phone: 626-382-2020
  • Fax:
Mailing address:
  • Phone: 949-285-8059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License NumberA71033
License Number StateCA

VIII. Authorized Official

Name: LINDA VU
Title or Position: PRESIDENT
Credential: MD
Phone: 949-285-8059