Healthcare Provider Details

I. General information

NPI: 1346277159
Provider Name (Legal Business Name): GIAO VAN VU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 11/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1863 ALUM ROCK AVE SUITE D
SAN JOSE CA
95116-1397
US

IV. Provider business mailing address

1863 ALUM ROCK AVE SUITE D
SAN JOSE CA
95116-1397
US

V. Phone/Fax

Practice location:
  • Phone: 408-254-0118
  • Fax: 408-254-2142
Mailing address:
  • Phone: 408-254-0118
  • Fax: 408-254-2142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA46581
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA46581
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: