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
Fax: (310) 301-8751
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033168042 NPPES
California MEDICAID 00A510190

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