Provider Demographics
NPI:1528473576
Name:THAI, JENNY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:
Last Name:THAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16182 HUXLEY CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-7707
Mailing Address - Country:US
Mailing Address - Phone:714-829-6265
Mailing Address - Fax:
Practice Address - Street 1:2240 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-5301
Practice Address - Country:US
Practice Address - Phone:310-325-0868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-29
Last Update Date:2014-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist