Provider Demographics
NPI:1225092877
Name:THOMAS, MOHSEN T (MD)
Entity Type:Individual
Prefix:
First Name:MOHSEN
Middle Name:T
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 N AKERS
Mailing Address - Street 2:STE A
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291
Mailing Address - Country:US
Mailing Address - Phone:559-625-5210
Mailing Address - Fax:559-625-6031
Practice Address - Street 1:128 N AKERS
Practice Address - Street 2:STE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291
Practice Address - Country:US
Practice Address - Phone:559-625-5210
Practice Address - Fax:559-625-6031
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48297207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A482970Medicare PIN
F47702Medicare UPIN