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General NPI Number Information
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NPI Number | 1831110766
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Entity Type | Organization
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Legal Business Name | GEORGE THOMPSON JR. M.D. INC.
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 1141 W REDONDO BEACH BLVD SUITE 311
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City | GARDENA
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State | CA
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Zip | 90247-3586
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Country | US
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Telephone | 310-327-5552
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Fax | 310-324-0693
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Provider Business Mailing Address
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Address Line | 1141 W REDONDO BEACH BLVD SUITE 311
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City | GARDENA
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State | CA
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Zip | 90247-3586
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Country | US
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Telephone | 310-327-5552
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Fax | 310-324-0693
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE THOMPSON JR.
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Credential | M.D.
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Telephone | 310-327-5552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 05D0547779
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 05D0717956
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | C27063
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License Number State | CA
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