MEDICARE: DR. THOMAS CLARK OLIVER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC26463	CA

General Provider Information

NPI Number	:	1013043645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS CLARK OLIVER D.C.

Provider Business Mailing Address
First Line	:	3020 PACIFIC AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-3639
Country	:	US
Telephone Number	:	209-466-1234
Fax Number	:	209-466-6181

Provider Business Practice Location Address
First Line	:	3020 PACIFIC AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-4919
Country	:	US
Telephone Number	:	209-466-1234
Fax Number	:	209-466-6181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	12/02/2025

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