MEDICARE: MR. MICHAEL JAMES THOMAS MSW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1346307584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL JAMES THOMAS MSW

Provider Business Mailing Address
First Line	:	5640 HIGHLAND AVE
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-5010
Country	:	US
Telephone Number	:	510-234-7230
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BOLIVAR DR
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-2210
Country	:	US
Telephone Number	:	510-649-1177
Fax Number	:	510-649-0322

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

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