Provider Demographics
NPI:1093126849
Name:GOSLIN, THOMAS PAUL
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PAUL
Last Name:GOSLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7202
Mailing Address - Country:US
Mailing Address - Phone:530-899-3790
Mailing Address - Fax:530-899-3890
Practice Address - Street 1:211 W EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7202
Practice Address - Country:US
Practice Address - Phone:530-899-3790
Practice Address - Fax:530-899-3890
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31296183500000X
NV06948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist