| Doctor Name: | DR. VICKY NINH MAI |
| NPI Number: | 1346300191 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O |
| License Number: | 20A7549 |
| Business Practice Address: | 4244 Riverwalk Pkwy Ste 150 Riverside, CA - 925053373 |
| Business Phone Number: | 9517816335 |
| Business Fax Number: | 9517816365 |
| Mailing Address: | 4310 Orange St, RIVERSIDE |
| State: | CA |
| Postal Code: | 925013829 |
| Phone Number: | 9517816335 |
| Fax Number: | 9512087244 |
| NPI Enumeration Date: | 12/11/2006 |
| NPI Last Update Date: | 09/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20A7549 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |