Provider Demographics
NPI:1548429863
Name:THOMPSON, CHERYL EMILY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:EMILY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1000 VALE TERRACE DR
Mailing Address - Street 2:VCC - GRAPEVINE
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-5218
Mailing Address - Country:US
Mailing Address - Phone:760-631-5000
Mailing Address - Fax:760-414-3892
Practice Address - Street 1:134 GRAPEVINE RD
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-4004
Practice Address - Country:US
Practice Address - Phone:760-631-5000
Practice Address - Fax:760-414-3892
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA102687261QF0400X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)