Provider Demographics
NPI:1770508848
Name:THOMAS, JOSEPH N (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:N
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10322 WEDDINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-3527
Mailing Address - Country:US
Mailing Address - Phone:310-804-2710
Mailing Address - Fax:
Practice Address - Street 1:9449 SAN FERNANDO RD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-1421
Practice Address - Country:US
Practice Address - Phone:818-252-2490
Practice Address - Fax:818-587-2493
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75200207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A752000OtherBLUE SHIELD
CA00A752000Medicaid
CAP00207212OtherRAILROAD MEDICARE
CA00A752000OtherBLUE SHIELD
CAH97515Medicare UPIN