Provider Demographics
NPI:1760463780
Name:THIO, WARREN W (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:W
Last Name:THIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WARREN
Other - Middle Name:W
Other - Last Name:THIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:941 24TH ST
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-2761
Mailing Address - Country:US
Mailing Address - Phone:202-531-3011
Mailing Address - Fax:
Practice Address - Street 1:941 24TH ST
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2761
Practice Address - Country:US
Practice Address - Phone:202-531-3011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76462207R00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine