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NPI Code Detail

MEDICARE: THOMAS GILLIAM

MEDICARE: THOMAS GILLIAM
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
1225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1235789355
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS GILLIAM
Provider Business Mailing Address
First Line : 615 W CIVIC CENTER DR STE 200
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-4052
Country : US
Telephone Number : 714-795-3444
Fax Number : 714-795-3443
Provider Business Practice Location Address
First Line : 615 W CIVIC CENTER DR
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-4006
Country : US
Telephone Number : 714-795-3444
Fax Number : 714-795-3443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2019
Last Update Date : 12/16/2025

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Directions to “ THOMAS GILLIAM ” Practice Location

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