Individual
MS. ANDREA MINOR THACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3100 SUMMIT ST FL 2, OAKLAND, CA 94609-3412
(510) 204-3410
(510) 204-3411
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 204-3410
(510) 204-3411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53457
CA
207R00000X
Internal Medicine Physician
MD00021008
WA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
G53457
CA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
MD00021008
WA
Other
Enumeration date
05/17/2006
Last updated
09/09/2020
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