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NPI Code Detail

MEDICARE: DR. KIM VU DDS

MEDICARE: DR. KIM VU DDS
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
11223G0001XGeneral Practice Dentistry39722CA

General Provider Information

NPI Number : 1851536395
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIM VU DDS
Provider Business Mailing Address
First Line : 40 HILLSDALE MALL,
Second Line : SEARS BLDG, 1ST FLOOR
City : SAN MATEO
State : CA
Zip : 94403-3407
Country : US
Telephone Number : 650-212-1999
Fax Number : 650-212-2299
Provider Business Practice Location Address
First Line : 40 HILLSDALE MALL,
Second Line : SEARS BLDG, 1ST FLOOR
City : SAN MATEO
State : CA
Zip : 94403-3407
Country : US
Telephone Number : 650-212-1999
Fax Number : 650-212-2299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2008
Last Update Date : 12/12/2008

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