Individual
DR. LY THIEN MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
424 S 56TH ST STE 120, PHOENIX, AZ 85034-2177
(602) 685-5211
(602) 685-5325
Mailing address
PO BOX 42210, PHOENIX, AZ 85080-2210
(623) 266-7770
(623) 322-4639
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
47836
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
825075
—
AZ
Enumeration date
05/31/2011
Last updated
08/04/2020
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