Healthcare Provider Details

I. General information

NPI: 1932060829
Provider Name (Legal Business Name): MARIA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 INLAND EMPIRE BLVD STE 180
ONTARIO CA
91764-5575
US

IV. Provider business mailing address

3200 INLAND EMPIRE BLVD STE 180
ONTARIO CA
91764-5575
US

V. Phone/Fax

Practice location:
  • Phone: 909-935-3268
  • Fax: 909-935-2685
Mailing address:
  • Phone: 909-935-3268
  • Fax: 909-935-2685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: