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General NPI Number Information
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NPI Number | 1780912683
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Entity Type | Individual
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Provider Name | JAMES DONALD THOMAS MD
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Gender | Male
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Dates
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Enumeration Date | 12/03/2009
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 9900 BALBOA BLVD STE E
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City | NORTHRIDGE
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State | CA
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Zip | 91325-5419
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Country | US
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Telephone | 818-701-0017
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Fax | 818-701-0073
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Provider Business Mailing Address
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Address Line | 178 N OAK KNOLL AVE APT 2
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City | PASADENA
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State | CA
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Zip | 91101-1800
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Country | US
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Telephone | 626-696-3991
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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 | G21216
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License Number State | CA
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