Healthcare Provider Details

I. General information

NPI: 1124050216
Provider Name (Legal Business Name): JOHN D. VU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 LA CASA VIA STE 140
WALNUT CREEK CA
94598-3084
US

IV. Provider business mailing address

2855 MITCHELL DR STE 223
WALNUT CREEK CA
94598-1609
US

V. Phone/Fax

Practice location:
  • Phone: 925-274-2860
  • Fax: 925-932-4527
Mailing address:
  • Phone: 925-975-5944
  • Fax: 925-975-5943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA77271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: