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General NPI Number Information
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NPI Number | 1962525006
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Entity Type | Organization
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Legal Business Name | CHAU TON-THAT,D.O.,INC.
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 9533 BOLSA AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-5904
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Country | US
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Telephone | 714-531-8720
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Fax | 714-531-5794
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Provider Business Mailing Address
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Address Line | 4131 COSTERO RISCO
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-6408
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Country | US
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Telephone | 949-584-4034
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Fax | 949-218-8173
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Authorized Official
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Title or Position | DR.
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Name | DR. CHAU TON-THAT
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Credential | D.O.
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Telephone | 949-699-3445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20A7177
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License Number State | CA
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