Basic Information
| Provider Information | |||||||||
| NPI: | 1750447199 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VUE | ||||||||
| FirstName: | DENG | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | COUNSELOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3046 SONATA CIR | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952123837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099380228 | ||||||||
| FaxNumber: | 2099380281 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 N EL DORADO ST | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952021305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099380228 | ||||||||
| FaxNumber: | 2099380281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2800X | 39-07 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic |
No ID Information.