Physician Compare National (NPI:1104920297)

HEALTHCARE PROVIDER: MAIYA DRUE THAO DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1104920297
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850467937
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080915000324
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	THAO
	Individual professional last name
Provider First Name	MAIYA
	Individual professional first name
Provider Middle Name	D
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4789678111
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	29
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	378 W OLIVE AVE C
	Group Practice or individual's line 1 address
Line 2 Street Address	MFA PODIATRY
	Group Practice or individual's line 2 address
City	MERCED
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	953483182
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2093843198
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y