Provider Demographics
NPI:1629102900
Name:THOMURE, RALPH MILTON (CAS)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:MILTON
Last Name:THOMURE
Suffix:
Gender:M
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 STATE HWY 49
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667
Mailing Address - Country:US
Mailing Address - Phone:530-626-4448
Mailing Address - Fax:530-626-4448
Practice Address - Street 1:2914A COLD SPRINGS RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-4220
Practice Address - Country:US
Practice Address - Phone:530-642-1715
Practice Address - Fax:530-642-2064
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA03-046633174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA03-046633OtherCAS