Healthcare Provider Details

I. General information

NPI: 1265423487
Provider Name (Legal Business Name): THOMAS S. LOSSING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E OCEAN AVE SUITE A
LOMPOC CA
93436-7081
US

IV. Provider business mailing address

1201 E OCEAN AVE SUITE A
LOMPOC CA
93436-7082
US

V. Phone/Fax

Practice location:
  • Phone: 805-735-3511
  • Fax: 805-737-1774
Mailing address:
  • Phone: 805-735-3511
  • Fax: 805-737-1774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG17265
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: