Provider Demographics
NPI: | 1770766834 |
---|---|
Name: | VO, THOI THANH (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | THOI |
Middle Name: | THANH |
Last Name: | VO |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | DR |
Other - First Name: | VO |
Other - Middle Name: | THANH |
Other - Last Name: | THOI |
Other - Suffix: | |
Other - Last Name Type: | Other Name |
Other - Credentials: | MD, DBA |
Mailing Address - Street 1: | 250 HOSPITAL CIR |
Mailing Address - Street 2: | |
Mailing Address - City: | WESTMINSTER |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92683-3953 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 714-890-6644 |
Mailing Address - Fax: | 714-890-3200 |
Practice Address - Street 1: | 250 HOSPITAL CIR |
Practice Address - Street 2: | |
Practice Address - City: | WESTMINSTER |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92683-3953 |
Practice Address - Country: | US |
Practice Address - Phone: | 714-890-6644 |
Practice Address - Fax: | 714-899-3493 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-12-12 |
Last Update Date: | 2021-06-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A39943 | 208D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
005728216A | Other | HIC | |
1102072781160 | Other | ICN | |
7103304075922 | Other | AR | |
CA | A00039943 | Medicaid | |
005728216A | Other | HIC | |
1102072781160 | Other | ICN | |
CA | A00039943 | Medicaid |