MEDICARE: DR. NHAT CONG VO M.D.

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	207R00000X	Internal Medicine Physician	A60568	CA
2	208000000X	Pediatrics Physician	A60568	CA

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	:	1215924451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NHAT CONG VO M.D.

Provider Business Mailing Address
First Line	:	865 PATRIOT DR
Second Line	:	STE102
City	:	MOORPARK
State	:	CA
Zip	:	93021-3407
Country	:	US
Telephone Number	:	805-532-2032
Fax Number	:	805-532-2844

Provider Business Practice Location Address
First Line	:	865 PATRIOT DR
Second Line	:	STE 102
City	:	MOORPARK
State	:	CA
Zip	:	93021-3407
Country	:	US
Telephone Number	:	805-532-2032
Fax Number	:	805-532-2844

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

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	11/14/2013

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