Provider Demographics
NPI:1497448880
Name:THALHOFER, PAUL TERRANCE
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:TERRANCE
Last Name:THALHOFER
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 1:1300 S GRAND AVE STE C-213
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4434
Mailing Address - Country:US
Mailing Address - Phone:714-567-5011
Mailing Address - Fax:714-567-7633
Practice Address - Street 1:1300 S GRAND AVE STE C-213
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4434
Practice Address - Country:US
Practice Address - Phone:714-567-5011
Practice Address - Fax:714-567-7633
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator