Healthcare Provider Details

I. General information

NPI: 1023481389
Provider Name (Legal Business Name): VICTOR C FU DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SANDPOINTE AVE SUITE #130
SANTA ANA CA
92707-5778
US

IV. Provider business mailing address

6 BRIARGLEN
IRVINE CA
92614-7598
US

V. Phone/Fax

Practice location:
  • Phone: 714-557-9292
  • Fax:
Mailing address:
  • Phone: 949-892-0495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: