Provider Demographics
NPI:1407072556
Name:THOMAS, RONALD PAUL (PTA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:PAUL
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 N ONTARIO ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-3009
Mailing Address - Country:US
Mailing Address - Phone:818-388-9463
Mailing Address - Fax:
Practice Address - Street 1:736 N ONTARIO ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-3009
Practice Address - Country:US
Practice Address - Phone:818-388-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3597225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant