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1427033646

NPI Code Detail

MEDICARE: RONALD W THOMPSON MD

MEDICARE: RONALD W THOMPSON MD

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	2085R0001X	Radiation Oncology Physician	G12376	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WG12376K	OTHER	CA	MEDICARE EL CEN
3	00G123761	OTHER	CA	MEDICARE TEM
4	WG12376F	OTHER	CA	MEDICARE SJHC
5	WG12376I	OTHER	CA	MEDICARE LCM
6	WG12376J	OTHER	CA	MEDICARE SAN PEDRO
7	WG12376C	OTHER	CA	MEDICARE VROC
8	00G123762	OTHER	CA	MEDICARE SBMC
10	WG12376G	OTHER	CA	MEDICARE - SJMC
11	00G123761	OTHER	CA	MEDICARE RIV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	G12376	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1427033646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD W THOMPSON MD

Provider Business Mailing Address
First Line	:	PO BOX 512185
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-0185
Country	:	US
Telephone Number	:	626-775-3514
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 SANTA MONICA BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2303
Country	:	US
Telephone Number	:	310-829-8913
Fax Number	:	310-315-6168

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

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	11/16/2020

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Directions to “ RONALD W THOMPSON MD” Practice Location

Language	Start Address	Practice Location

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