Provider Demographics
NPI:1609212968
Name:THOMAS I REVESZ MD
Entity Type:Organization
Organization Name:THOMAS I REVESZ MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:REVESZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-331-1333
Mailing Address - Street 1:5444 LAUREL HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-3106
Mailing Address - Country:US
Mailing Address - Phone:916-331-1333
Mailing Address - Fax:916-331-1820
Practice Address - Street 1:5444 LAUREL HILLS DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-3106
Practice Address - Country:US
Practice Address - Phone:916-331-1333
Practice Address - Fax:916-331-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA522940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty