Individual provider Active NPI

Danh Thanh Vu, PA

  • Physician Assistant
  • Garden Grove, CA
National Provider Identifier
1558958710
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA59395 Issued in CA
Practice address
10090 Westminster Ave
Garden Grove, CA 92843-4721
Phone
(714) 251-3226
NPI assigned
Dec 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA59395 CA Primary

Addresses

Primary practice location

10090 Westminster Ave
Garden Grove, CA 92843-4721

Mailing address

3600 Lime St Ste 516
Riverside, CA 92501-0944
Phone (951) 367-1060

Other practice location 1

3600 Lime St Ste 516
Riverside, CA 92501-0944
Phone (951) 367-1060

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212000452 CA Practitioner - Physician Assistant 2668908708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11190 Warner Ave
Suite 408
Fountain Valley, CA 92708-4047
Phone (714) 430-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA59395CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Vascular and Endovascular Surgery Center Inc CurrentSince Sep 5, 2024 Accepting new patients
Shams Iqbal Inc PastSince Sep 5, 2023 Accepting new patients

Locations

11190 Warner Ave
Ste 408
Fountain Vly, CA 92708
Phone (714) 430-1414

Interoperability endpoints

  • Direct secure messaging: dvu839213@direct.memorialcare.org

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1558958710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIME ST STE 516",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925010944",
            "telephone_number": "951-367-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10090 WESTMINSTER AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434721",
            "telephone_number": "714-251-3226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Lime St Ste 516",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925010944",
            "country_code": "US",
            "telephone_number": "951-367-1060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VU",
        "first_name": "DANH",
        "middle_name": "THANH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-22",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.