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General NPI Number Information
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NPI Number | 1336376052
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Entity Type | Individual
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Provider Name | THOMAS F LYONS JR. RM
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Gender | Male
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Dates
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Enumeration Date | 06/20/2009
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Last Update Date | 06/20/2009
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Provider Practice Location Address
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Address Line | 307 SAN VICENTE CIR
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City | PALM DESERT
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State | CA
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Zip | 92260-2152
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Country | US
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Telephone | 323-325-8681
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Fax | 206-350-2150
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Provider Business Mailing Address
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Address Line | PO BOX 1814
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1059
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Country | US
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Telephone | 323-325-8681
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Fax | 206-350-2150
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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