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NPI Code Detail

MEDICARE: DR. THOMAS H VAN M.D.

MEDICARE:  DR. THOMAS H VAN  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
1207Q00000XFamily Medicine PhysicianA061189CA

General Provider Information

NPI Number : 1619937877
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS H VAN M.D.
Provider Business Mailing Address
First Line : 440 E HUNTINGTON DR
Second Line : SUITE 200
City : ARCADIA
State : CA
Zip : 91006-3776
Country : US
Telephone Number : 626-254-8246
Fax Number : 626-254-8236
Provider Business Practice Location Address
First Line : 2600 REDONDO AVE
Second Line : 303
City : LONG BEACH
State : CA
Zip : 90806-2329
Country : US
Telephone Number : 562-988-7000
Fax Number : 562-988-7201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 01/15/2013

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Directions to “ DR. THOMAS H VAN M.D.” Practice Location

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