Healthcare Provider Details

I. General information

NPI: 1326098179
Provider Name (Legal Business Name): TIN T HLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JOSE FIGUERES AVE SUITE 430
SAN JOSE CA
95116-1500
US

IV. Provider business mailing address

200 JOSE FIGUERES AVE SUITE 430
SAN JOSE CA
95116-1500
US

V. Phone/Fax

Practice location:
  • Phone: 408-929-6088
  • Fax: 408-929-6087
Mailing address:
  • Phone: 408-929-6088
  • Fax: 408-929-6087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA36657
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA36657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: