Provider Demographics
NPI:1326584095
Name:THOMAS, STEPHEN PAUL II (NP)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:PAUL
Last Name:THOMAS
Suffix:II
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3660 PARK SIERRA DR STE 203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3071
Mailing Address - Country:US
Mailing Address - Phone:951-687-3400
Mailing Address - Fax:951-687-7630
Practice Address - Street 1:31537 RANCHO PUEBLO RD
Practice Address - Street 2:#201
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4857
Practice Address - Country:US
Practice Address - Phone:951-687-7140
Practice Address - Fax:951-303-3565
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95005872363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95005872OtherNP LICENSE