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General NPI Number Information
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NPI Number | 1336554542
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Entity Type | Organization
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Legal Business Name | KATHY VU NGO, PLLC
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 06/26/2014
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Provider Practice Location Address
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Address Line | 11851 N 51ST AVE SUITE 120
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City | GLENDALE
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State | AZ
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Zip | 85304-2809
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Country | US
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Telephone | 623-414-6476
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Fax |
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Provider Business Mailing Address
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Address Line | 11851 N 51ST AVE SUITE 120
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City | GLENDALE
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State | AZ
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Zip | 85304-2809
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Country | US
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Telephone | 623-414-6476
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KATHY VU
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Credential |
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Telephone | 347-733-4797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1631
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License Number State | AZ
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