Provider Demographics
NPI:1508906272
Name:HA, THUY THI (OD)
Entity Type:Individual
Prefix:
First Name:THUY
Middle Name:THI
Last Name:HA
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:9717 ELK GROVE FLORIN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2262
Mailing Address - Country:US
Mailing Address - Phone:916-685-3369
Mailing Address - Fax:916-685-2020
Practice Address - Street 1:9717 ELK GROVE FLORIN RD
Practice Address - Street 2:SUITE B
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2262
Practice Address - Country:US
Practice Address - Phone:916-685-3369
Practice Address - Fax:916-685-2020
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2021-12-30
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Provider Licenses
StateLicense IDTaxonomies
CAOPT13097152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADH912ZMedicare PIN