Healthcare Provider Details

I. General information

NPI: 1831162999
Provider Name (Legal Business Name): THOMAS C O'NEIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W EATON AVE
TRACY CA
95376
US

IV. Provider business mailing address

PO BOX 986
WOODBRIDGE CA
95258-0986
US

V. Phone/Fax

Practice location:
  • Phone: 209-836-1155
  • Fax: 209-836-0478
Mailing address:
  • Phone: 209-836-1155
  • Fax: 209-836-0478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA34142
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: