MEDICARE: TUONG T HA 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	207R00000X	Internal Medicine Physician	A43426	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568447860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TUONG T HA M.D.

Provider Business Mailing Address
First Line	:	933 SOLEM ST
Second Line	:
City	:	AZUSA
State	:	CA
Zip	:	91702-4253
Country	:	US
Telephone Number	:	626-280-2803
Fax Number	:	626-280-6124

Provider Business Practice Location Address
First Line	:	530 W BADILLO ST
Second Line	:	#E
City	:	COVINA
State	:	CA
Zip	:	91722-3787
Country	:	US
Telephone Number	:	626-280-2803
Fax Number	:	626-280-6124

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	06/15/2011

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