Provider Demographics
NPI:1487117339
Name:VU, QUAN (DO)
Entity type:Individual
Prefix:
First Name:QUAN
Middle Name:
Last Name:VU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 OMAHA AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-7616
Mailing Address - Country:US
Mailing Address - Phone:559-273-3422
Mailing Address - Fax:
Practice Address - Street 1:45 E RIVER PARK PL W
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1562
Practice Address - Country:US
Practice Address - Phone:559-603-7326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19896207R00000X
KS9410074207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine