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NPI Code Detail

MEDICARE: THOMAS J CACHUR JR D O A PROFESSIONAL MEDICAL CORPORATION

MEDICARE: THOMAS J CACHUR JR D O A PROFESSIONAL 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
1207V00000XObstetrics & Gynecology Physician20A9086CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992994628
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS J CACHUR JR D O A PROFESSIONAL MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 1414 S GRAND AVE STE 382
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3072
Country : US
Telephone Number : 213-747-7307
Fax Number : 213-747-7093
Provider Business Practice Location Address
First Line : 1414 S GRAND AVE STE 382
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3072
Country : US
Telephone Number : 213-747-7307
Fax Number : 213-747-7093
Authorized Official
Title or Position : OWNER
Name : THOMAS J CACHUR JR.
Credential :
Telephone Number : 213-747-7307
Provider Enumeration Date : 10/18/2007
Last Update Date : 02/12/2008

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