Provider Demographics
NPI:1942221346
Name:VU, TONY DUY (OD)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:DUY
Last Name:VU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18430 BROOKHURST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6726
Mailing Address - Country:US
Mailing Address - Phone:714-968-9121
Mailing Address - Fax:714-962-6521
Practice Address - Street 1:18430 BROOKHURST ST STE 100
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6726
Practice Address - Country:US
Practice Address - Phone:714-968-9121
Practice Address - Fax:714-962-6521
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11285TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP11285AMedicaid
CAWOP11285AMedicaid