Provider Demographics
NPI:1609036169
Name:THOI LIEN MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:THOI LIEN MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOI
Authorized Official - Middle Name:HUE
Authorized Official - Last Name:LIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-280-5035
Mailing Address - Street 1:6113 N MUSCATEL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-2624
Mailing Address - Country:US
Mailing Address - Phone:626-287-7022
Mailing Address - Fax:626-280-0428
Practice Address - Street 1:8054 GARVEY AVE STE 201
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2449
Practice Address - Country:US
Practice Address - Phone:626-280-5035
Practice Address - Fax:626-280-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA75628OtherCA STATE LICENSE
CA00A756280Medicaid
CABL6840169OtherDEA
CAA75628Medicare PIN
CAH78393Medicare UPIN