Provider Demographics
NPI:1760658900
Name:VAN, THIEN HIEU (MD)
Entity Type:Individual
Prefix:MR
First Name:THIEN
Middle Name:HIEU
Last Name:VAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11301 WILSHIRE BLVD
Mailing Address - Street 2:VHA (VA GREATER LOS ANGELES HEALTHCARE SYSTEM)
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-1003
Mailing Address - Country:US
Mailing Address - Phone:310-478-3711
Mailing Address - Fax:661-632-1886
Practice Address - Street 1:1801 WESTWIND DR RM 318
Practice Address - Street 2:VA CBOC BAKERSFIELD PRIMARY CARE
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3028
Practice Address - Country:US
Practice Address - Phone:661-632-1800
Practice Address - Fax:661-632-1886
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2016-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301091205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine