Provider Demographics
NPI:1356324909
Name:NEUSCHATZ, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:NEUSCHATZ
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:PO BOX 949
Mailing Address - Street 2:8676 MARYSVILLE RD
Mailing Address - City:OREGON HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95962-0949
Mailing Address - Country:US
Mailing Address - Phone:530-692-2050
Mailing Address - Fax:530-692-2053
Practice Address - Street 1:1560 HUMBOLDT RD
Practice Address - Street 2:ST 5
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-9101
Practice Address - Country:US
Practice Address - Phone:530-692-2050
Practice Address - Fax:530-692-2053
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC41964207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37715Medicare UPIN