Provider Demographics
NPI:1922079110
Name:THOMAS, MATTHEW MORRILL (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MORRILL
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 1:10666 N TORREY PINES RD
Mailing Address - Street 2:URGENT CARE
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1027
Mailing Address - Country:US
Mailing Address - Phone:858-554-8638
Mailing Address - Fax:
Practice Address - Street 1:435 SANTA FE DR
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5134
Practice Address - Country:US
Practice Address - Phone:760-633-7686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2016-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76430208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice