Provider Demographics
NPI:1023514122
Name:DANG, THAI SON (DO)
Entity type:Individual
Prefix:DR
First Name:THAI
Middle Name:SON
Last Name:DANG
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1180 N INDIAN CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4800
Mailing Address - Country:US
Mailing Address - Phone:714-791-4788
Mailing Address - Fax:
Practice Address - Street 1:700 US HIGHWAY 46 STE 420
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1532
Practice Address - Country:US
Practice Address - Phone:973-882-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALDO.32522084N0400X
FLOS201022084N0400X
NY3226692084N0400X
NC2023-006712084N0400X
SC2084N0400X2084N0400X
SD142522084N0400X
VA01022078462084N0400X
NJ25MB117905002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology