MEDICARE: THOMAS T. HA, M.D., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A43426	CA

General Provider Information

NPI Number	:	1194257618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS T. HA, M.D., INC.

Provider Business Mailing Address
First Line	:	23541 RIDGE LINE RD
Second Line	:
City	:	DIAMOND BAR
State	:	CA
Zip	:	91765-3008
Country	:	US
Telephone Number	:	626-367-1033
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 W BADILLO ST
Second Line	:	SUITE E
City	:	COVINA
State	:	CA
Zip	:	91722-3787
Country	:	US
Telephone Number	:	626-858-5370
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS T. HA
Credential	:	M.D
Telephone Number	:	626-367-1033

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	04/03/2017

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