Basic Information
Provider Information
NPI: 1386178234
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VO
FirstName: ANTHONY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18217 HALE AVE
Address2:  
City: MORGAN HILL
State: CA
PostalCode: 950373550
CountryCode: US
TelephoneNumber: 4084658280
FaxNumber: 4084658281
Practice Location
Address1: 18217 HALE AVE
Address2:  
City: MORGAN HILL
State: CA
PostalCode: 950373550
CountryCode: US
TelephoneNumber: 4084658280
FaxNumber: 4084658281
Other Information
ProviderEnumerationDate: 04/18/2017
LastUpdateDate: 06/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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