Healthcare Provider Details

I. General information

NPI: 1255270823
Provider Name (Legal Business Name): MR. ISAIAH THOMPSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 BLANCO CIR
SALINAS CA
93901-4401
US

IV. Provider business mailing address

913 BLANCO CIR
SALINAS CA
93901-4401
US

V. Phone/Fax

Practice location:
  • Phone: 831-424-6655
  • Fax: 831-424-9717
Mailing address:
  • Phone: 831-424-6655
  • Fax: 831-424-9717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: