Healthcare Provider Details

I. General information

NPI: 1669166831
Provider Name (Legal Business Name): CHRISTINE THU DO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9960 BALDWIN PL
EL MONTE CA
91731-2204
US

IV. Provider business mailing address

1115 S SUNSET AVE
WEST COVINA CA
91790-3940
US

V. Phone/Fax

Practice location:
  • Phone: 323-644-3880
  • Fax:
Mailing address:
  • Phone: 626-732-8390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A24986
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: