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General NPI Number Information
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NPI Number | 1750652137
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Entity Type | Organization
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Legal Business Name | THOMAS TRI QUACH, MD, INC
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 9186 BOLSA AVENUE
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City | WESTMINSTER
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State | CA
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Zip | 92648
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Country | US
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Telephone | 714-799-7522
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Fax | 714-799-7523
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Provider Business Mailing Address
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Address Line | 9186 BOLSA AVENUE
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City | WESTMINSTER
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State | CA
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Zip | 92648
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Country | US
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Telephone | 714-799-7522
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Fax | 714-799-7523
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS QUACH
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Credential | MD
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Telephone | 714-235-6753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G080556
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License Number State | CA
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