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General NPI Number Information
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NPI Number | 1073625232
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Entity Type | Organization
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Legal Business Name | DIEUMY MICHELLE THAI, MD, INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/21/2008
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Provider Practice Location Address
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Address Line | 16401 MAGNOLIA ST
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City | WESTMINSTER
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State | CA
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Zip | 92683-7827
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Country | US
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Telephone | 714-596-4288
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Fax | 714-596-2388
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Provider Business Mailing Address
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Address Line | 16401 MAGNOLIA ST
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City | WESTMINSTER
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State | CA
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Zip | 92683-7827
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Country | US
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Telephone | 714-596-4288
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Fax | 714-596-2388
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHELLE THAI
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Credential | MD
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Telephone | 714-596-4288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | G644010
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | G644010
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | G644010
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License Number State | CA
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