Healthcare Provider Details

I. General information

NPI: 1265643969
Provider Name (Legal Business Name): SETH CHRISTOPHER THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 LONE TREE WAY DEPARTMENT OF EMERGENCY MEDICINE
ANTIOCH CA
94509-6200
US

IV. Provider business mailing address

3901 LONE TREE WAY DEPARTMENT OF EMERGENCY MEDICINE
ANTIOCH CA
94509-6200
US

V. Phone/Fax

Practice location:
  • Phone: 925-779-7200
  • Fax:
Mailing address:
  • Phone: 925-779-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA100722
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA100722
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: