Healthcare Provider Details

I. General information

NPI: 1841568425
Provider Name (Legal Business Name): SCOTT P THOMAS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 S SUNRISE WAY
PALM SPRINGS CA
92262-0118
US

IV. Provider business mailing address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-3593
  • Fax: 760-969-7781
Mailing address:
  • Phone: 760-340-3911
  • Fax: 760-674-3845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO 1799
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A11923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: