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NPI Code Detail

MEDICARE: DR. THOMAS JOSEPH EARLY MD

MEDICARE: DR. THOMAS JOSEPH EARLY 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
1207QA0505XAdult Medicine PhysicianG27175CA

General Provider Information

NPI Number : 1679808117
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS JOSEPH EARLY MD
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD
Second Line : SUITE 400
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-302-1317
Fax Number : 310-302-1417
Provider Business Practice Location Address
First Line : 5767 W CENTURY BLVD
Second Line : SUITE 400
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-302-1317
Fax Number : 310-302-1417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2009
Last Update Date : 10/15/2009

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