Individual
NINA NGAN THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
207 W LEGION RD, BRAWLEY, CA 92227
(760) 351-3333
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RE3008
GU
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95000144
CA
367500000X
Certified Registered Nurse Anesthetist
NP0020
GU
Other
Enumeration date
12/28/2010
Last updated
04/06/2021
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