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General NPI Number Information
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NPI Number | 1871410951
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Entity Type | Individual
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Provider Name | ROBERT KENNETH THIEL
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Gender | Male
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 97 DOBBINS ST
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City | VACAVILLE
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State | CA
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Zip | 95688-2700
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Country | US
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Telephone | 707-887-3651
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Fax |
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Provider Business Mailing Address
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Address Line | 86 LIDO CIR
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City | SACRAMENTO
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State | CA
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Zip | 95826-1613
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Country | US
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Telephone | 209-201-3211
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G68346
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License Number State | CA
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