MEDICARE: TAMKHIET THANH-HO JENKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1437432101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMKHIET THANH-HO JENKINS

Provider Business Mailing Address
First Line	:	UCLA LUSKIN SCHOOL OF PUBLIC AFFAIRS
Second Line	:	3250 PUBLIC AFFAIRS BUILDING, BOX 951656
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-1656
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	UCLA LUSKIN SCHOOL OF PUBLIC AFFAIRS
Second Line	:	3250 PUBLIC AFFAIRS BUILDING, BOX 951656
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-1656
Country	:	US
Telephone Number	:	303-916-9658
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	09/20/2011

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