Provider Demographics
NPI:1104100221
Name:THORNG, SEIHA (DPM)
Entity type:Individual
Prefix:
First Name:SEIHA
Middle Name:
Last Name:THORNG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W ACACIA ST STE 18
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95203-2441
Mailing Address - Country:US
Mailing Address - Phone:209-425-4846
Mailing Address - Fax:209-425-0570
Practice Address - Street 1:420 W ACACIA ST STE 18
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95203-2441
Practice Address - Country:US
Practice Address - Phone:209-425-4846
Practice Address - Fax:209-425-0570
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1267213ES0103X
CAE5293213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery