Basic Information
| Provider Information | |||||||||
| NPI: | 1437131703 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VU | ||||||||
| FirstName: | ANDREA | ||||||||
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| Credential: | MD. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24355 LYONS AVENUE | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | SANTA CLARITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913212381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612229381 | ||||||||
| FaxNumber: | 6612222264 | ||||||||
| Practice Location | |||||||||
| Address1: | 9879 KY ROUTE 122 | ||||||||
| Address2: | |||||||||
| City: | MC DOWELL | ||||||||
| State: | KY | ||||||||
| PostalCode: | 416476042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6063773400 | ||||||||
| FaxNumber: | 6063773466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2005 | ||||||||
| LastUpdateDate: | 10/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | TP191 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.