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General NPI Number Information
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NPI Number | 1992371074
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Entity Type | Organization
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Legal Business Name | ANDREW J THOMAS MD INC
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Dates
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Enumeration Date | 05/31/2021
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 123 MARGARET LN STE B1
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5268
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Country | US
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Telephone | 530-410-0368
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Fax | 530-410-0864
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Provider Business Mailing Address
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Address Line | 123 MARGARET LN STE C1
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5268
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Country | US
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Telephone | 530-410-0368
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Fax | 530-410-0864
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW J THOMAS
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Credential | MD
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Telephone | 530-410-0368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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