MEDICARE: THOMAS P. ENGEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	G641690	CA

General Provider Information

NPI Number	:	1013992726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS P. ENGEL M.D.

Provider Business Mailing Address
First Line	:	11234 ANDERSON ST RM 2532
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:	909-558-4475
Fax Number	:	916-734-2975

Provider Business Practice Location Address
First Line	:	11234 ANDERSON ST RM 2532
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:	909-558-4475
Fax Number	:	916-734-2975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	10/12/2018

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