MEDICARE: DR. GARY H. THOMAS PHARM D

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	183500000X	Pharmacist	30003	CA

General Provider Information

NPI Number	:	1144536798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY H. THOMAS PHARM D

Provider Business Mailing Address
First Line	:	7122-A CALABRIA CT.
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122
Country	:	US
Telephone Number	:	619-284-3345
Fax Number	:

Provider Business Practice Location Address
First Line	:	6505 MISSION GORGE RD.
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120
Country	:	US
Telephone Number	:	619-284-3345
Fax Number	:	619-284-6549

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

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	08/20/2010

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