Marie-Josee Thibault
Dermatologist MOHS-Micrographic Surgeon
5767 W Century Blvd Suite 200
Los Angeles
, California 90045-5632
Marie-Josee Thibault
Dermatologist MOHS-Micrographic Surgeon
5767 W Century Blvd Suite 200
Los Angeles
, California 90045-5632
(310) 301-8751
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About
Features
Specialties
- Dermatologist
- MOHS-Micrographic Surgeon
Languages spoken
- English
Location
First Address
- Marie-Josee Thibault
- 1615 Highway 34 E Ste B
- Newnan, GA
- Zip : 30265-1325
- Fax : (310) 301-8751
- Phone : (310) 301-8708
Second Address
- Marie-Josee Thibault
- 5767 W Century Blvd Suite 200
- Los Angeles, CA
- Zip : 90045-5632
- Fax : (310) 301-8751
- Phone : (310) 301-8708
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207N00000X | Dermatologist | 84458 | GA |
| Y | 207N00000X | Dermatologist | A51019 | CA |
| N | 207ND0101X | MOHS-Micrographic Surgeon | A51019 | CA |
National Provider Identifier
| NPI | 1033168042 |
|---|---|
| Provider Name | Marie-Josee Thibault |
| First Address | Newnan, GA 30265-1325 |
| Second Address | Los Angeles, CA 90045-5632 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/05/2006 |
| Last Update Date | 06/11/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00A510190 | (05) | CA |
| F54111 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.