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NPI Code Detail

MEDICARE: DR. JOHN THAI DC

MEDICARE: DR. JOHN THAI DC
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
1111N00000XChiropractorDC36144CA

General Provider Information

NPI Number : 1669140083
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN THAI DC
Provider Business Mailing Address
First Line : 1432 W SAN CARLOS ST APT 142
Second Line :
City : SAN JOSE
State : CA
Zip : 95126-3217
Country : US
Telephone Number : 408-717-3919
Fax Number :
Provider Business Practice Location Address
First Line : 1280 BENTON ST
Second Line :
City : SANTA CLARA
State : CA
Zip : 95050-4805
Country : US
Telephone Number : 408-717-3919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2021
Last Update Date : 11/21/2021

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Directions to “ DR. JOHN THAI DC” Practice Location

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