Provider Demographics
NPI:1558505750
Name:MAI, THINH DUY (MD)
Entity Type:Individual
Prefix:
First Name:THINH
Middle Name:DUY
Last Name:MAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 VICTORY LN STE A
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5920
Mailing Address - Country:US
Mailing Address - Phone:408-363-6533
Mailing Address - Fax:408-784-3453
Practice Address - Street 1:61 VICTORY LN STE A
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5920
Practice Address - Country:US
Practice Address - Phone:408-363-6533
Practice Address - Fax:408-784-3453
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1072892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA107289OtherLICENSE