Healthcare Provider Details

I. General information

NPI: 1831227461
Provider Name (Legal Business Name): THOMAS A JONES MD A PROFFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 E VALLEY PKWY SUITE 210
ESCONDIDO CA
92025-3363
US

IV. Provider business mailing address

PO BOX 33865
SAN DIEGO CA
92163-3865
US

V. Phone/Fax

Practice location:
  • Phone: 760-738-0224
  • Fax: 760-738-1768
Mailing address:
  • Phone: 858-888-7700
  • Fax: 858-888-7721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberG51735
License Number StateCA

VIII. Authorized Official

Name: DR. THOMAS A JONES
Title or Position: PHYSICIAN
Credential: MD
Phone: 760-738-0224