Healthcare Provider Details

I. General information

NPI: 1649467325
Provider Name (Legal Business Name): HANNAH VU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3374 S BRISTOL ST
SANTA ANA CA
92704-8203
US

IV. Provider business mailing address

3374 S BRISTOL ST
SANTA ANA CA
92704-8203
US

V. Phone/Fax

Practice location:
  • Phone: 714-361-1555
  • Fax: 714-361-1556
Mailing address:
  • Phone: 714-361-1550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberG80124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: