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General NPI Number Information
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NPI Number | 1942364328
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Entity Type | Individual
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Provider Name | THOMAS M FITZGERALD MD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 1601 PRECISION PARK LN
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City | SAN DIEGO
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State | CA
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Zip | 92173-1345
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Country | US
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Telephone | 619-662-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 3830 VALLEY CENTRE DR # 705649
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City | SAN DIEGO
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State | CA
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Zip | 92130-3320
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Country | US
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Telephone | 704-894-9309
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Fax | 704-894-9304
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 93-00112
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | A48795
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 93-00112
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A48795
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License Number State | CA
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