Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A70925 | CA |
N | 111NI0900X | Internist | A70925 | CA |
Y | 207RA0401X | Internist - Addiction Medicine | A70925 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | A70925 | CA |
NPI | 1760423560 |
---|---|
Provider Name | Dr. Aung Thu |
First Address | Hemet, CA 92543-4437 |
Second Address | Hemet, CA 92543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 03/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A709251 | CALIFORNIA LICENSE (01) | CA |
201088839 | TAX ID (01) | CA |
H13345 | (02) | CA |