Individual
VITUNE VONGTAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4722 QUAIL LAKES DR, STOCKTON, CA 95207-5244
(209) 472-1848
(209) 472-0133
Mailing address
3742 MERRIMAC CIRCLE, STOCKTON, CA 95219
(209) 473-8710
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A29753
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A297530
—
CA
Enumeration date
06/29/2006
Last updated
10/21/2022
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