Organization Name: | LUYEN V. TA, M.D., INC/TUONG-VI TA, M.D. |
NPI Number: | 1720334279 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TUONG-VI TA (PRESIDENT) |
Mailing Address: | 341 9th Street Suite A Oakland |
State: | CA US |
Postal Code: | 94607 |
Phone Number: | 5108361095 |
Fax Number: | 5108361096 |
NPI Enumeration Date: | 08/01/2012 |
NPI Last Update Date: | 08/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A37356 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |