Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 1267 | MA |
Y | 213ES0103X | Foot & Ankle Surgery | E5293 | CA |
NPI | 1104100221 |
---|---|
Provider Name | Seiha Thorng |
First Address | Stockton, CA 95203-2441 |
Second Address | Stockton, CA 95203-2441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2011 |
Last Update Date | 12/10/2021 |