1588850713 NPI number — DR. VIVIENNE SINH HAU M.D., PH.D.

Table of content: DR. VIVIENNE SINH HAU M.D., PH.D. (NPI 1588850713)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588850713 NPI number — DR. VIVIENNE SINH HAU M.D., PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAU
Provider First Name:
VIVIENNE
Provider Middle Name:
SINH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAU
Provider Other First Name:
VINCENT
Provider Other Middle Name:
SINH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588850713
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 650037
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75265-0037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-696-2008
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10800 MAGNOLIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92505-3043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-323-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  N3077 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 202923301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202923305 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202923303 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202923306 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202923302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202923304 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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