Provider Demographics
NPI:1376802579
Name:THOMAS R POWERS MD. INC
Entity Type:Organization
Organization Name:THOMAS R POWERS MD. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-889-0422
Mailing Address - Street 1:20055 LAKE CHABOT RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5331
Mailing Address - Country:US
Mailing Address - Phone:510-889-0422
Mailing Address - Fax:510-538-8343
Practice Address - Street 1:20055 LAKE CHABOT RD
Practice Address - Street 2:SUITE 350
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5331
Practice Address - Country:US
Practice Address - Phone:510-889-0422
Practice Address - Fax:510-538-8343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23847283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital