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General NPI Number Information
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NPI Number | 1629515036
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Entity Type | Individual
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Provider Name | THOMAS ROBERT SURNOCK D.C
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Gender | Male
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 140 N HILL AVE
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City | PASADENA
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State | CA
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Zip | 91106-1907
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Country | US
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Telephone | 626-792-3390
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Fax |
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Provider Business Mailing Address
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Address Line | 2404 AVONDALE DR
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City | ALHAMBRA
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State | CA
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Zip | 91803-3747
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Country | US
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Telephone | 323-833-3400
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC33382
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License Number State | CA
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