Provider Demographics
NPI:1578589560
Name:TRINH, THANH-MAI (MD)
Entity Type:Individual
Prefix:
First Name:THANH-MAI
Middle Name:
Last Name:TRINH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10212 WESTMINSTER AVE
Mailing Address - Street 2:114
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4800
Mailing Address - Country:US
Mailing Address - Phone:714-638-1864
Mailing Address - Fax:714-638-1964
Practice Address - Street 1:10212 WESTMINSTER AVE
Practice Address - Street 2:114
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4800
Practice Address - Country:US
Practice Address - Phone:714-638-1864
Practice Address - Fax:714-638-1964
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60206207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A602060Medicaid
CAA602060Medicare ID - Type Unspecified
CA00A602060Medicaid