Provider Demographics
NPI:1922856111
Name:VUONG, LINH MAI (PA-C)
Entity type:Individual
Prefix:
First Name:LINH
Middle Name:MAI
Last Name:VUONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 LENNON LN STE 200
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2543
Mailing Address - Country:US
Mailing Address - Phone:925-685-4224
Mailing Address - Fax:925-685-6997
Practice Address - Street 1:215 LENNON LN STE 200
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2543
Practice Address - Country:US
Practice Address - Phone:925-685-4224
Practice Address - Fax:925-685-6997
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-11
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64611207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine