Provider Demographics
NPI:1619993045
Name:THOMAS S. LOSSING INC. AMC
Entity Type:Organization
Organization Name:THOMAS S. LOSSING INC. AMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:LOSSING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-735-3511
Mailing Address - Street 1:1201 E OCEAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-7081
Mailing Address - Country:US
Mailing Address - Phone:805-735-3511
Mailing Address - Fax:805-737-1774
Practice Address - Street 1:1201 E OCEAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7081
Practice Address - Country:US
Practice Address - Phone:805-735-3511
Practice Address - Fax:805-737-1774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG-17265207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40034Medicare UPIN
CAG-017265Medicare ID - Type Unspecified