Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | G64729 | CA |
NPI | 1043224587 |
---|---|
Provider Name | Christine T Thai |
First Address | Huntington Beach, CA 92648-2996 |
Second Address | Huntington Beach, CA 92648-2996 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 07/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F28670 | (02) |