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General NPI Number Information
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NPI Number | 1184782302
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Entity Type | Individual
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Provider Name | KENNETH DOUGLAS THRASHER D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 45280 SEELEY DR ARGYROS HEALTH CENTER, 2ND FLOOR
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City | LA QUINTA
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State | CA
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Zip | 92253-6834
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Country | US
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Telephone | 760-834-7920
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Fax | 760-834-7921
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Provider Business Mailing Address
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Address Line | 45280 SEELEY DR ARGYRO HEALTH CENTER, 2ND FLOOR
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City | LA QUINTA
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State | CA
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Zip | 92253-6834
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Country | US
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Telephone | 760-834-7920
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Fax | 760-834-7921
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102201120
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP60091631
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A11578
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License Number State | CA
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