Provider Demographics
NPI:1558661934
Name:THUC T. BACH, M.D., INC.
Entity Type:Organization
Organization Name:THUC T. BACH, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THUC
Authorized Official - Middle Name:THE
Authorized Official - Last Name:BACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-796-8945
Mailing Address - Street 1:960 E GREEN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2401
Mailing Address - Country:US
Mailing Address - Phone:626-796-8945
Mailing Address - Fax:626-796-9061
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-796-8945
Practice Address - Fax:626-796-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31717174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA31717Medicare PIN