Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edwin MA Thao

Individual provider Pharmacist · NPI 1871069310

Edwin MA Thao is a Pharmacist in Coon Rapids, Minnesota. Licensed in California and Minnesota. Registered with an NPI since 2018.

Licensed in
CA, MN
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

11850 Blackfoot St NW Ste 190
Coon Rapids, MN 55433-2583
Phone: (763) 236-7111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 125332 (MN)
Pharmacist Taxonomy 183500000X · Licence 79678 (CA)

Record details

NPI number1871069310
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 23, 2018
Last updated in NPPESSeptember 12, 2022
Certification dateSeptember 12, 2022
Mailing address18212 79th Pl N, Maple Grove, MN 55311-1911

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