Thibault, Marie-Josee
Thibault, Marie-Josee is an individual health care provider with primary practice located at 5767 W Century Blvd Suite 200, Los Angeles CA 90045-5632. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Thibault, Marie-Josee can be contacted via phone (310) 301-8708.Contact Information
Primary practice address
5767 W Century Blvd Suite 200
Los Angeles CA 90045-5632
Phone: (310) 301-8708
Fax: (310) 301-8751
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 84458 | Georgia |
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | A51019 | California |
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | A51019 | California |
Profile Details
NPI number | 1033168042 |
---|---|
LBN Legal business name | Thibault, Marie-Josee |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 8th, 2006 |
Last updated | Nov 6th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1033168042 | NPPES |
California | MEDICAID | 00A510190 |
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