Provider Demographics
NPI:1851556195
Name:BRAD THOMAS, MD, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BRAD THOMAS, MD, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-318-5333
Mailing Address - Street 1:3701 SKYPARK DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4753
Mailing Address - Country:US
Mailing Address - Phone:310-791-7998
Mailing Address - Fax:
Practice Address - Street 1:3701 SKYPARK DR
Practice Address - Street 2:SUITE 240
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4753
Practice Address - Country:US
Practice Address - Phone:310-791-7998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72166207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty