Provider Demographics
NPI:1942639331
Name:DOAN, THANH HA (CMT)
Entity Type:Individual
Prefix:
First Name:THANH HA
Middle Name:
Last Name:DOAN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12832 GARDEN GROVE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-2014
Mailing Address - Country:US
Mailing Address - Phone:714-467-0293
Mailing Address - Fax:714-467-0293
Practice Address - Street 1:12832 GARDEN GROVE BLVD STE B
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2014
Practice Address - Country:US
Practice Address - Phone:714-467-0293
Practice Address - Fax:714-467-0293
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1098174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist