Healthcare Provider Details

I. General information

NPI: 1033418348
Provider Name (Legal Business Name): THOMAS RIMMER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N JOHNSON AVE
EL CAJON CA
92020-1650
US

IV. Provider business mailing address

1400 N JOHNSON AVE
EL CAJON CA
92020-1650
US

V. Phone/Fax

Practice location:
  • Phone: 619-442-0277
  • Fax:
Mailing address:
  • Phone: 619-442-0277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: