Healthcare Provider Details

I. General information

NPI: 1841515574
Provider Name (Legal Business Name): YEN-TRANG XUAN VO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5317 E 16TH ST
INDIANAPOLIS IN
46218-4897
US

IV. Provider business mailing address

5317 E 16TH ST
INDIANAPOLIS IN
46218-4897
US

V. Phone/Fax

Practice location:
  • Phone: 463-218-7731
  • Fax:
Mailing address:
  • Phone: 463-218-7731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A12252
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02007330A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP70095061
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: