Provider Demographics
NPI:1518616473
Name:VO, BRIAN PHU (OD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PHU
Last Name:VO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:4731 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-2693
Mailing Address - Country:US
Mailing Address - Phone:817-791-4654
Mailing Address - Fax:
Practice Address - Street 1:2260 CALLAGAN HWY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92136-2152
Practice Address - Country:US
Practice Address - Phone:619-550-2679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-19
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35248TLG152W00000X
OHOPT.007098152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist