Healthcare Provider Details

I. General information

NPI: 1609036169
Provider Name (Legal Business Name): THOI LIEN MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 03/07/2023
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8054 GARVEY AVE STE 201
ROSEMEAD CA
91770-2449
US

IV. Provider business mailing address

6113 N MUSCATEL AVE
SAN GABRIEL CA
91775-2624
US

V. Phone/Fax

Practice location:
  • Phone: 626-280-5035
  • Fax: 626-280-0428
Mailing address:
  • Phone: 626-287-7022
  • Fax: 626-280-0428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. THOI HUE LIEN
Title or Position: SOLE OWNER
Credential: M.D.
Phone: 626-280-5035