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General NPI Number Information
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NPI Number | 1891834404
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Entity Type | Organization
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Legal Business Name | ROBERT M THOMAS JR MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 3900 5TH AVE SUITE 270
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City | SAN DIEGO
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State | CA
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Zip | 92103-3121
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Country | US
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Telephone | 619-298-1000
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Fax | 619-298-4619
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Provider Business Mailing Address
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Address Line | 3900 5TH AVE SUITE 270
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City | SAN DIEGO
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State | CA
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Zip | 92103-3121
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Country | US
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Telephone | 619-298-1000
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Fax | 619-298-4619
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT M THOMAS JR.
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Credential | MD
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Telephone | 619-298-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C31483
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License Number State | CA
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