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NPI Code Detail

MEDICARE: ERIC THOMAS

MEDICARE: ERIC THOMAS
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
1247200000XOther Technician

General Provider Information

NPI Number : 1659883932
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC THOMAS
Provider Business Mailing Address
First Line : 2010 LINCOLN PARK AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3119
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2010 LINCOLN PARK AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3119
Country : US
Telephone Number : 323-222-1440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2017
Last Update Date : 10/26/2017

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Directions to “ ERIC THOMAS ” Practice Location

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