Most Relevant Information
Provider Data
| NPI Number: | 1003356684 |
| Provider Name: | DON VONGVIPHUT DO |
| Entity Type: | Individual |
| Taxonomy Code: | 208D00000X |
| Specialty: | General Practice |
| License Number: | 02005485A |
Most Important Dates
| Enumeration Date: | 03/02/2017 |
| Last Updated: | 03/29/2019 |
Provider Practice Location
3458 NEELY RD
FLIGHT MEDICINE CLINIC
JOINT BASE MCGUIRE-DIX-LAKEHURST
NJ
08641
Practice Location Phone/Fax
| Phone: | 6097549080 |
| Fax: |
Provider Mailing Location
5109 BINDEWALD RD
TORRANCE
CA
905054312
Provider Mailing Phone/Fax
| Phone: | 6507145919 |
| Fax: |