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General NPI Number Information
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NPI Number | 1801870035
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Entity Type | Individual
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Provider Name | KONRAD BOYD THOMAS MD
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Gender | Male
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2185 W GRANT LINE RD 2ND FLOOR
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City | TRACY
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State | CA
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Zip | 95377-7309
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Country | US
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Telephone | 209-839-3300
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Fax | 209-839-6310
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Provider Business Mailing Address
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Address Line | 2185 W GRANT LINE RD 2ND FLOOR
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City | TRACY
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State | CA
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Zip | 95377-7309
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Country | US
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Telephone | 209-839-3300
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Fax | 209-839-6310
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD053008L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01052897A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 75587
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G87954
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License Number State | CA
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