Individual provider Active NPI

Lac Vu, M.D.

  • Specialist
  • San Diego, CA
National Provider Identifier
1497828255
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A54417 Issued in CA
Practice address
5555 Reservoir Dr Ste 205
San Diego, CA 92120-5148
Phone
(619) 286-5858
Fax
(619) 286-1474
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A54417 CA Primary

Addresses

Primary practice location

5555 Reservoir Dr Ste 205
San Diego, CA 92120-5148

Mailing address

5555 Reservoir Dr Ste 205
San Diego, CA 92120-5148
Phone (619) 286-5858

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
I20230130000556 CA Practitioner - Obstetrics/Gynecology 2264803287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Nebraska College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5555 Reservoir Dr
Suite 205
San Diego, CA 92120-5148
Phone (619) 286-5858

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A54417CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Nov 13, 2025 Accepting new patients
Lac T Vu CurrentSince Oct 1, 2022 Accepting new patients
Sharp Memorial Hospital PastSince Oct 1, 2022 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

5555 Reservoir Dr
Ste 205
San Diego, CA 92120
Phone (619) 286-5858

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497828255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205148",
            "telephone_number": "619-286-5858",
            "fax_number": "619-286-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205148",
            "telephone_number": "619-286-5858",
            "fax_number": "619-286-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "LAC",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A54417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.