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NPI Code Detail

MEDICARE: HANH THAI

MEDICARE: HANH THAI
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
1183500000XPharmacist69885CA

General Provider Information

NPI Number : 1548699259
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANH THAI
Provider Business Mailing Address
First Line : 15376 ROCHELLE ST
Second Line :
City : FONTANA
State : CA
Zip : 92336-1040
Country : US
Telephone Number : 909-379-5170
Fax Number :
Provider Business Practice Location Address
First Line : 33975 DATE PALM DR
Second Line :
City : CATHEDRAL CITY
State : CA
Zip : 92234-4736
Country : US
Telephone Number : 760-202-3533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2013
Last Update Date : 11/03/2013

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Directions to “ HANH THAI ” Practice Location

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