Provider Demographics
NPI:1952543563
Name:M DAVID THIER MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:M DAVID THIER MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TREASURER/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:THIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-425-3862
Mailing Address - Street 1:1020 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3813
Mailing Address - Country:US
Mailing Address - Phone:415-425-3862
Mailing Address - Fax:415-563-9770
Practice Address - Street 1:2300 CALIFORNIA ST
Practice Address - Street 2:300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2753
Practice Address - Country:US
Practice Address - Phone:415-425-3862
Practice Address - Fax:415-563-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA20927207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty