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General NPI Number Information
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NPI Number | 1972751998
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Entity Type | Individual
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Provider Name | PAUL DUY TAN VU M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 4950 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90027-5822
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Country | US
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Telephone | 323-341-6085
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 10TH ST
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-6208
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Country | US
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Telephone | 310-995-4842
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A103918
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License Number State | CA
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