Healthcare Provider Details

I. General information

NPI: 1184122624
Provider Name (Legal Business Name): VM MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2018
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8251 WESTMINSTER BLVD STE 110
WESTMINSTER CA
92683-3370
US

IV. Provider business mailing address

8251 WESTMINSTER BLVD STE 110
WESTMINSTER CA
92683-3370
US

V. Phone/Fax

Practice location:
  • Phone: 714-839-5898
  • Fax: 855-227-7512
Mailing address:
  • Phone: 714-839-5898
  • Fax: 855-227-7512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NGUYEN LU
Title or Position: OFFICE MANAGER
Credential:
Phone: 714-471-3038