Individual
E MICHAEL THELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4944 SUNRISE BLVD, STE A, FAIR OAKS, CA 95628
(916) 966-5171
Mailing address
4944 SUNRISE BLVD, STE A, FAIR OAKS, CA 95628
(916) 966-5171
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
G27470
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G27470
—
CA
Enumeration date
12/14/2005
Last updated
09/17/2010
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