MEDICARE: VU DINH D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	5315026344	MI
2	208600000X	Surgery Physician	255566	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093928079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VU DINH D.O.

Provider Business Mailing Address
First Line	:	PO BOX 2337
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13220-2337
Country	:	US
Telephone Number	:	315-701-5610
Fax Number	:	315-701-5608

Provider Business Practice Location Address
First Line	:	425 OLD NEWPORT BLVD
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4250
Country	:	US
Telephone Number	:	949-438-2476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	11/27/2023

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Directions to “ VU DINH D.O.” Practice Location

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