Healthcare Provider Details

I. General information

NPI: 1902283443
Provider Name (Legal Business Name): THOMAS ONYIA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 12/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR # MC8770
SAN DIEGO CA
92103-1911
US

IV. Provider business mailing address

27700 MEDICAL CENTER RD
MISSION VIEJO CA
92691-6426
US

V. Phone/Fax

Practice location:
  • Phone: 310-528-9922
  • Fax: 619-543-5424
Mailing address:
  • Phone: 310-528-9922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number149440
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR74956
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: