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General NPI Number Information
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NPI Number | 1417938630
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Entity Type | Individual
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Provider Name | PATRICK S THOMPSON MD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 26538 MOULTON PKWY STE 38E
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City | ALISO VIEJO
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State | CA
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Zip | 92653
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Country | US
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Telephone | 949-448-0656
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Fax |
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Provider Business Mailing Address
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Address Line | 17360 BROOKHURST ST ATTN: MCMF - CREDENTIALING DEPARTMENT
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-3720
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Country | US
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Telephone |
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Fax |
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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 | G45100
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License Number State | CA
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