Individual provider Active NPI

Phu Luong Thi Vo, DO

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1043849177
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A19395 Issued in CA
Practice address
4690 El Cajon Blvd
San Diego, CA 92115-4403
Phone
(619) 445-6200
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A19395 CA Primary

Addresses

Primary practice location

4690 El Cajon Blvd
San Diego, CA 92115-4403

Mailing address

4690 El Cajon Blvd
San Diego, CA 92115-4403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231005003453 CA Practitioner - Family Practice 6103271416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro de Salud de la Comunidad de San Ysidro,Inc.Group PAC ID 6901709435, 291 clinicians

Practice addresses (Care Compare)

4690 El Cajon Blvd
San Diego, CA 92115-4403
Phone (619) 662-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A19395CAMDFamily Medicine Physician
19395CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Oct 2, 2023 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Oct 2, 2023 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

4690 El Cajon Blvd
San Diego, CA 92115
Phone (619) 478-5254

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pvo31981@syhealth.direct-ci.com
  • Direct secure messaging: phuluong.vo.p1@direct.cmcentersinc.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1043849177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154403",
            "telephone_number": "619-445-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "PHU LUONG",
        "middle_name": "THI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A19395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.