Provider Demographics
NPI:1669556866
Name:AHN, THOMAS G (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:AHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2080 CENTURY PARK E STE 1410
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2017
Mailing Address - Country:US
Mailing Address - Phone:310-277-7600
Mailing Address - Fax:310-553-9103
Practice Address - Street 1:2080 CENTURY PARK EAST
Practice Address - Street 2:SUITE 1410
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067
Practice Address - Country:US
Practice Address - Phone:310-277-7600
Practice Address - Fax:310-221-8839
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61939207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism