MEDICARE: THOMAS CALVERT 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	256526	MA
2	208800000X	Urology Physician	A162971	CA

General Provider Information

NPI Number	:	1982042677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS CALVERT M.D.

Provider Business Mailing Address
First Line	:	3650 SOUTH ST STE 408
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90712-1510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 SOUTH ST STE 408
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90712-1510
Country	:	US
Telephone Number	:	562-630-0423
Fax Number	:

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

Provider Enumeration Date	:	06/05/2013
Last Update Date	:	06/13/2022

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Directions to “ THOMAS CALVERT M.D.” Practice Location

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