Healthcare Provider Details

I. General information

NPI: 1306777677
Provider Name (Legal Business Name): MAX THAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S 12TH AVE
HANFORD CA
93230-6176
US

IV. Provider business mailing address

2425 S CLAREMONT AVE
FRESNO CA
93727-9038
US

V. Phone/Fax

Practice location:
  • Phone: 559-583-6393
  • Fax:
Mailing address:
  • Phone: 559-708-3945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: