Healthcare Provider Details

I. General information

NPI: 1407903347
Provider Name (Legal Business Name): DON VAN VUONG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7445 S DURANGO DR STE 105
LAS VEGAS NV
89113-3611
US

IV. Provider business mailing address

7445 S DURANGO DR STE 105
LAS VEGAS NV
89113-3611
US

V. Phone/Fax

Practice location:
  • Phone: 702-453-5000
  • Fax: 702-453-3007
Mailing address:
  • Phone: 702-453-5000
  • Fax: 702-453-3007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01097
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-30011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: