Healthcare Provider Details

I. General information

NPI: 1144141292
Provider Name (Legal Business Name): MICHAEL THOMAS MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 3100
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4900 T ST
SACRAMENTO CA
95819-4833
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-0391
  • Fax:
Mailing address:
  • Phone: 279-248-7369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberSPI975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: