Provider Demographics
NPI:1508028846
Name:THOMSON, EMILY JAMIE (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:JAMIE
Last Name:THOMSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:ELORIAGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25460 MEDICAL CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5985
Mailing Address - Country:US
Mailing Address - Phone:951-677-4748
Mailing Address - Fax:951-677-6529
Practice Address - Street 1:25460 MEDICAL CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-677-4748
Practice Address - Fax:951-677-6529
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-01043207V00000X
VA0102203426207V00000X
CA20A15493207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVA702AMedicare PIN