Organization Active NPI

Lac T Vu

  • Obstetrics Physician
  • San Diego, CA
National Provider Identifier
1912629080
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
LAC T VU
Practice address
5555 Reservoir Dr Ste 205
San Diego, CA 92120-5148
Phone
(619) 286-5858
NPI assigned
Sep 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Lac Vu, MDNPI 1497828255
Title
Owner
Phone
(619) 286-5858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230130000506 CA Part B Supplier - Clinic/Group Practice 1355712373 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1912629080",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAC T VU",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "LAC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-286-5858",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.