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NPI Code Detail

MEDICARE: THU DO

MEDICARE:   THU  DO
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1619479227
Entity Type Code : Individual
Provider Name (Legal Business Name) : THU DO
Provider Business Mailing Address
First Line : 39420 LIBERTY ST STE 150
Second Line :
City : FREMONT
State : CA
Zip : 94538-2284
Country : US
Telephone Number : 510-794-5155
Fax Number :
Provider Business Practice Location Address
First Line : 39420 LIBERTY ST STE 150
Second Line :
City : FREMONT
State : CA
Zip : 94538-2284
Country : US
Telephone Number : 510-794-5155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2018
Last Update Date : 02/28/2018

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Directions to “ THU DO ” Practice Location

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