Provider Demographics
NPI:1154468924
Name:AUNG THU MD INC
Entity Type:Organization
Organization Name:AUNG THU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:THU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-929-5537
Mailing Address - Street 1:245 LAURSEN ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4437
Mailing Address - Country:US
Mailing Address - Phone:951-929-5537
Mailing Address - Fax:951-929-9761
Practice Address - Street 1:245 LAURSEN ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4437
Practice Address - Country:US
Practice Address - Phone:951-929-5537
Practice Address - Fax:951-929-9761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70925174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherIRS
CAH13345Medicare UPIN