Provider Demographics
NPI:1508065053
Name:THUO, JAMES C (RN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:THUO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:C
Other - Last Name:THUO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1441 MADRID DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-7502
Mailing Address - Country:US
Mailing Address - Phone:302-388-7853
Mailing Address - Fax:
Practice Address - Street 1:1441 MADRID DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-7502
Practice Address - Country:US
Practice Address - Phone:302-388-7853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95358662163W00000X
DEL20009260164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse