Provider Demographics
NPI:1891736468
Name:RIOS, TOMAS B (MD)
Entity Type:Individual
Prefix:
First Name:TOMAS
Middle Name:B
Last Name:RIOS
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 1:7513 DOS RIOS WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-2715
Mailing Address - Country:US
Mailing Address - Phone:661-549-1182
Mailing Address - Fax:661-326-8375
Practice Address - Street 1:148 E KINGS ST
Practice Address - Street 2:
Practice Address - City:AVENAL
Practice Address - State:CA
Practice Address - Zip Code:93204-1529
Practice Address - Country:US
Practice Address - Phone:559-386-9000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54078207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A540780Medicaid
CA00A540780Medicaid
CA00A540780Medicare ID - Type UnspecifiedMEDICARE