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General NPI Number Information
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NPI Number | 1548459480
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Entity Type | Organization
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Legal Business Name | NANCY S. THORNER, MD, INC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 555 SOQUEL AVENUE SUITE 360
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City | SANTA CRUZ
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State | CA
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Zip | 95062
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Country | US
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Telephone | 831-476-3363
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Fax | 831-476-6837
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Provider Business Mailing Address
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Address Line | 555 SOQUEL AVENUE SUITE 360
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City | SANTA CRUZ
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State | CA
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Zip | 95062
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Country | US
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Telephone | 831-476-3363
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Fax | 831-476-6837
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Authorized Official
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Title or Position | CEO
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Name | NANCY S THORNER
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Credential | M.D.
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Telephone | 831-476-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G57135
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License Number State | CA
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