Healthcare Provider Details

I. General information

NPI: 1659310902
Provider Name (Legal Business Name): CHRISTOPHER MINH VU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1642 E CAPITOL EXPY
SAN JOSE CA
95121-1800
US

IV. Provider business mailing address

1642 E CAPITOL EXPY
SAN JOSE CA
95121-1800
US

V. Phone/Fax

Practice location:
  • Phone: 408-270-3374
  • Fax: 408-270-3384
Mailing address:
  • Phone: 408-270-3374
  • Fax: 408-270-3384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA065143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: