Provider Demographics
NPI:1922005859
Name:JONES, THOMAS ALLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALLYN
Last Name:JONES
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:PO BOX 33865
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92163-3865
Mailing Address - Country:US
Mailing Address - Phone:858-888-7700
Mailing Address - Fax:858-888-7721
Practice Address - Street 1:215 S HICKORY ST
Practice Address - Street 2:SUITE 114
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4359
Practice Address - Country:US
Practice Address - Phone:760-743-5111
Practice Address - Fax:858-429-7934
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-04-02
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
CAG51735208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAED640YOtherMEDICARE PTAN FOR GHP
CA00G517350Medicaid
CAG51735Medicare UPIN