Healthcare Provider Details

I. General information

NPI: 1780638049
Provider Name (Legal Business Name): THOMAS A GIONIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 STUDEBAKER RD
NORWALK CA
90650-2531
US

IV. Provider business mailing address

DEPT LA 21575
PASADENA CA
91185-1575
US

V. Phone/Fax

Practice location:
  • Phone: 562-864-6377
  • Fax:
Mailing address:
  • Phone: 949-263-8620
  • Fax: 949-263-0473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC39248
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: