Provider Demographics
NPI:1609041789
Name:VO, PHUC H (DO)
Entity type:Individual
Prefix:
First Name:PHUC
Middle Name:H
Last Name:VO
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:PHUC
Other - Middle Name:H
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:18715 WESTWIND ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7269
Mailing Address - Country:US
Mailing Address - Phone:303-356-1738
Mailing Address - Fax:
Practice Address - Street 1:4041 MACARTHUR BLVD STE 400
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2554
Practice Address - Country:US
Practice Address - Phone:303-356-1738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21831207QH0002X
TXN8131207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX282752901Medicaid
TXP01003032OtherRAILROAD
TX282752902Medicaid
TXTXB130896Medicare PIN
TXTXB130895Medicare PIN