Healthcare Provider Details

I. General information

NPI: 1760634778
Provider Name (Legal Business Name): KEVIN A VU M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6830 STOCKTON BLVD STE 155
SACRAMENTO CA
95823-2392
US

IV. Provider business mailing address

6830 STOCKTON BLVD STE 155
SACRAMENTO CA
95823-2392
US

V. Phone/Fax

Practice location:
  • Phone: 916-476-3008
  • Fax: 855-291-3367
Mailing address:
  • Phone: 916-476-3008
  • Fax: 916-720-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA105487
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA105487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: