MEDICARE: DR. THOMAS CHARLES GATES MD

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	2085R0001X	Radiation Oncology Physician	A23750	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023072915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS CHARLES GATES MD

Provider Business Mailing Address
First Line	:	PO BOX 575
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92564-0575
Country	:	US
Telephone Number	:	951-691-5123
Fax Number	:	951-691-5156

Provider Business Practice Location Address
First Line	:	1043 ELM AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-3271
Country	:	US
Telephone Number	:	951-691-5123
Fax Number	:	951-691-5156

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	02/11/2008

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