Healthcare Provider Details

I. General information

NPI: 1871337998
Provider Name (Legal Business Name): DEBI THOMAS MD, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8311 BRIMHALL RD STE 1903
BAKERSFIELD CA
93312-4367
US

IV. Provider business mailing address

4900 CALIFORNIA AVE STE 210B
BAKERSFIELD CA
93309-7080
US

V. Phone/Fax

Practice location:
  • Phone: 661-624-4931
  • Fax:
Mailing address:
  • Phone: 661-624-4931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBI THOMAS
Title or Position: PRESIDENT
Credential: MD
Phone: 661-624-4931