MEDICARE: RONALD C THURSTON MD A MEDICAL CORPORATION

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	2084P0800X	Psychiatry Physician	C-31856	CA

General Provider Information

NPI Number	:	1942447990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD C THURSTON MD A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	3311 OLD CONEJO RD
Second Line	:
City	:	NEWBURY PARK
State	:	CA
Zip	:	91320-2115
Country	:	US
Telephone Number	:	805-388-3337
Fax Number	:	805-388-1155

Provider Business Practice Location Address
First Line	:	3311 OLD CONEJO RD
Second Line	:
City	:	NEWBURY PARK
State	:	CA
Zip	:	91320-2115
Country	:	US
Telephone Number	:	805-388-3337
Fax Number	:	805-388-1155

Authorized Official
Title or Position	:	OWNER
Name	:	RONALD C THURSTON
Credential	:	MD
Telephone Number	:	805-388-3337

Provider Enumeration Date	:	01/13/2009
Last Update Date	:	09/02/2025

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