Provider Demographics
NPI:1336235662
Name:THEIN, PATRICK K (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:K
Last Name:THEIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:24692 DEL PRADO
Mailing Address - Street 2:SUITE A
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3841
Mailing Address - Country:US
Mailing Address - Phone:949-661-0510
Mailing Address - Fax:949-661-4819
Practice Address - Street 1:24692 DEL PRADO
Practice Address - Street 2:SUITE A
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3841
Practice Address - Country:US
Practice Address - Phone:949-661-0510
Practice Address - Fax:949-661-4819
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG58343207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF20374Medicare UPIN