Provider Demographics
NPI:1245234582
Name:MCCOMBS, THOMAS MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:MCCOMBS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 W AMERICAN CANYON RD
Mailing Address - Street 2:SUITE L4 PMB # 142
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-4196
Mailing Address - Country:US
Mailing Address - Phone:707-317-4070
Mailing Address - Fax:
Practice Address - Street 1:110 W AMERICAN CANYON RD
Practice Address - Street 2:SUITE L4 PMB # 142
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-4196
Practice Address - Country:US
Practice Address - Phone:707-317-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 5598204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine