Doctor Name: | SAY THAO |
NPI Number: | 1073807897 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 23214 |
Business Practice Address: | 45-280 Seeley Drive 2nd Floor La Quinta, CA - 922536834 |
Business Phone Number: | 7605682684 |
Business Fax Number: | 7608372241 |
Mailing Address: | P.o. Box 1730, Desert Orthopedic Center RANCHO MIRAGE |
State: | CA |
Postal Code: | 922701058 |
Phone Number: | 7605682684 |
Fax Number: | 7608372202 |
NPI Enumeration Date: | 06/09/2011 |
NPI Last Update Date: | 02/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 23214 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |