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Individual
DR. TAN DUY VU
Active
Individual
DR. TAN DUY VU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12670T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6143837
MEDICAID PIN
CA
05
—
SD0126700
—
CA
Enumeration date
05/22/2006
Last updated
12/01/2008
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