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General NPI Number Information
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NPI Number | 1417417510
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Entity Type | Individual
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Provider Name | CEDRIC N THIEL MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2019
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 259 TERRACINA BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4847
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Country | US
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Telephone | 909-335-4102
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Fax | 909-335-8710
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Provider Business Mailing Address
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Address Line | 11234 ANDERSON STREET ROOM 2586A
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City | LOMA LINDA
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State | CA
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Zip | 92350
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Country | US
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Telephone | 909-558-2454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | A201485
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License Number State | CA
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