Healthcare Provider Details

I. General information

NPI: 1093917080
Provider Name (Legal Business Name): LENG HENRY THAO DO, DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2007
Last Update Date: 12/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 W 8TH ST SUITE 101
HANFORD CA
93230-4533
US

IV. Provider business mailing address

314 N MAIN ST
PORTERVILLE CA
93257-3730
US

V. Phone/Fax

Practice location:
  • Phone: 559-587-4532
  • Fax: 559-589-1867
Mailing address:
  • Phone: 559-791-7000
  • Fax: 559-781-8193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A9920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: