Provider Demographics
NPI:1407406788
Name:TON-THAT, BINH HUNG
Entity Type:Individual
Prefix:
First Name:BINH
Middle Name:HUNG
Last Name:TON-THAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 THREADNEEDLE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1547
Mailing Address - Country:US
Mailing Address - Phone:901-701-7879
Mailing Address - Fax:
Practice Address - Street 1:4198 GION AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-1908
Practice Address - Country:US
Practice Address - Phone:901-701-7879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer