MEDICARE: THUAN DIEP M.D.

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	208000000X	Pediatrics Physician	A146685	CA

General Provider Information

NPI Number	:	1477948479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THUAN DIEP M.D.

Provider Business Mailing Address
First Line	:	12036 SCRIPPS HIGHLANDS DR STE 102
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-5155
Country	:	US
Telephone Number	:	858-566-4444
Fax Number	:	858-566-3321

Provider Business Practice Location Address
First Line	:	12036 SCRIPPS HIGHLANDS DR STE 102
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-5155
Country	:	US
Telephone Number	:	858-566-4444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2015
Last Update Date	:	04/26/2019

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