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General NPI Number Information
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NPI Number | 1164763231
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Entity Type | Organization
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Legal Business Name | ANNE THAI MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/14/2013
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 1720 EL CAMINO REAL SUITE NUMBER 155
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City | BURLINGAME
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State | CA
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Zip | 94010-3224
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Country | US
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Telephone | 650-685-6105
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 EL CAMINO REAL SUITE NUMBER 155
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City | BURLINGAME
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State | CA
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Zip | 94010-3224
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Country | US
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Telephone | 650-685-6105
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANNE THAI
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Credential | M.D.
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Telephone | 650-270-7117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A105658
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License Number State | CA
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