Provider Demographics
NPI:1164637005
Name:THRIFT, PRESTON P (IDC, RN)
Entity Type:Individual
Prefix:MR
First Name:PRESTON
Middle Name:P
Last Name:THRIFT
Suffix:
Gender:M
Credentials:IDC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35938 RHONE LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-9165
Mailing Address - Country:US
Mailing Address - Phone:951-926-0500
Mailing Address - Fax:
Practice Address - Street 1:53560 HULL ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92152-5001
Practice Address - Country:US
Practice Address - Phone:619-553-1536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman