Provider Demographics
NPI:1760423560
Name:THU, AUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:AUNG
Middle Name:
Last Name:THU
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 1:245 LAURSEN ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4437
Mailing Address - Country:US
Mailing Address - Phone:951-929-5537
Mailing Address - Fax:951-929-9761
Practice Address - Street 1:245 LAURSEN ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543
Practice Address - Country:US
Practice Address - Phone:951-929-5537
Practice Address - Fax:951-929-9761
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70925207R00000X, 207RH0002X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A709251OtherCALIFORNIA LICENSE
CA201088839OtherTAX ID
CA201088839OtherTAX ID
CAH13345Medicare UPIN