Provider Demographics
NPI:1548205503
Name:THOMAS, ALLEN ADOLPHUS III (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:ADOLPHUS
Last Name:THOMAS
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12062 VALLEY VIEW ST STE 133
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-1776
Mailing Address - Country:US
Mailing Address - Phone:714-892-0888
Mailing Address - Fax:
Practice Address - Street 1:12062 VALLEY VIEW ST STE 133
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-1776
Practice Address - Country:US
Practice Address - Phone:714-892-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0301560Medicare UPIN