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General NPI Number Information
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NPI Number | 1740421312
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Entity Type | Individual
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Provider Name | BETH N THOMPSON
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Gender | Female
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2337 MONTCLAIR ST
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City | SAN DIEGO
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State | CA
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Zip | 92104-5344
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Country | US
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Telephone | 619-987-4247
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Fax |
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Provider Business Mailing Address
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Address Line | 2337 MONTCLAIR ST
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City | SAN DIEGO
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State | CA
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Zip | 92104-5344
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Country | US
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Telephone | 619-793-4727
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Fax | 619-793-5514
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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 | 20A11378
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 20A11378
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License Number State | CA
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