MEDICARE: DR. THOMAS NELSON M.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	208600000X	Surgery Physician	61104	CA

General Provider Information

NPI Number	:	1497757132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS NELSON M.D.

Provider Business Mailing Address
First Line	:	5054 MILLAY CT
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-3869
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5054 MILLAY CT
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-3869
Country	:	US
Telephone Number	:	760-583-8004
Fax Number	:

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	01/26/2026

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