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General NPI Number Information
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NPI Number | 1164769535
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Entity Type | Organization
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Legal Business Name | GREGORY S THOMAS MD MPH CORPORATION
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Dates
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Enumeration Date | 01/05/2013
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Last Update Date | 01/05/2013
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Provider Practice Location Address
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Address Line | 2865 ATLANTIC AVE SUITE 104
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City | LONG BEACH
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State | CA
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Zip | 90806-1740
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Country | US
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Telephone | 562-933-1820
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Fax | 562-933-1819
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Provider Business Mailing Address
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Address Line | 32582 BALEARIC RD
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City | DANA POINT
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State | CA
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Zip | 92629-3613
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Country | US
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Telephone | 949-310-0246
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Fax | 562-933-1819
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY SCOTT THOMAS
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Credential | MD, MPH
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Telephone | 949-310-0246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G49797
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License Number State |
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