Provider Demographics
NPI:1548353352
Name:VU OPTOMETRY INC
Entity type:Organization
Organization Name:VU OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUYNH-NHU
Authorized Official - Middle Name:T
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-674-5057
Mailing Address - Street 1:18285 COLLIER AVE STE 1F
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-2786
Mailing Address - Country:US
Mailing Address - Phone:951-674-5057
Mailing Address - Fax:951-674-4392
Practice Address - Street 1:18285 COLLIER AVE STE 1F
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-2786
Practice Address - Country:US
Practice Address - Phone:951-674-5057
Practice Address - Fax:951-674-4392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0114970Medicaid