Provider Demographics
NPI:1881383818
Name:DO, KEVIN THANH (DC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:THANH
Last Name:DO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 SARATOGA AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3430
Mailing Address - Country:US
Mailing Address - Phone:408-430-3966
Mailing Address - Fax:
Practice Address - Street 1:940 SARATOGA AVE STE 109
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3430
Practice Address - Country:US
Practice Address - Phone:408-430-3966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor