Healthcare Provider Details

I. General information

NPI: 1497746663
Provider Name (Legal Business Name): TERENCE THOMPSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8833 RESEDA BLVD SUITE A
NORTHRIDGE CA
91324-5353
US

IV. Provider business mailing address

8833 RESEDA BLVD STE A
NORTHRIDGE CA
91324-5353
US

V. Phone/Fax

Practice location:
  • Phone: 818-341-0670
  • Fax: 818-341-0690
Mailing address:
  • Phone: 818-341-0670
  • Fax: 818-341-0690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA55500
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: