Healthcare Provider Details

I. General information

NPI: 1285196881
Provider Name (Legal Business Name): MARINA CLARISSA THOMAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARINA CLARISSA GERMANOS MD

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9455 CLAIREMONT MESA BLVD
SAN DIEGO CA
92123-1297
US

IV. Provider business mailing address

2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US

V. Phone/Fax

Practice location:
  • Phone: 858-688-2996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA181503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: