Provider Demographics
NPI:1457831372
Name:THANT, AYE AYE III
Entity Type:Individual
Prefix:
First Name:AYE
Middle Name:AYE
Last Name:THANT
Suffix:III
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 HARBOR BAY PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-6596
Mailing Address - Country:US
Mailing Address - Phone:510-835-2777
Mailing Address - Fax:510-835-0164
Practice Address - Street 1:1141 HARBOR BAY PKWY STE 105
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94502-6596
Practice Address - Country:US
Practice Address - Phone:510-835-2777
Practice Address - Fax:510-835-0164
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker