Provider Demographics
NPI:1922340579
Name:THOMAS, ANDREW JAMES (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAMES
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 1:123 MARGARET LN STE C1
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5268
Mailing Address - Country:US
Mailing Address - Phone:530-410-0368
Mailing Address - Fax:530-410-0864
Practice Address - Street 1:123 MARGARET LN STE B1
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5268
Practice Address - Country:US
Practice Address - Phone:530-410-0368
Practice Address - Fax:530-410-0864
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD186941207Y00000X
LA320754207Y00000X
CAC171386207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology