Provider Demographics
NPI:1134150980
Name:THOMAS H MURPHY OD INC
Entity type:Organization
Organization Name:THOMAS H MURPHY OD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BASKETT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-929-5909
Mailing Address - Street 1:5500 SUNRISE BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7641
Mailing Address - Country:US
Mailing Address - Phone:916-726-2020
Mailing Address - Fax:916-726-3937
Practice Address - Street 1:5500 SUNRISE BLVD
Practice Address - Street 2:STE 400
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7641
Practice Address - Country:US
Practice Address - Phone:916-726-2020
Practice Address - Fax:916-726-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA314522230OtherVSP, SUPERIOR
CAZZZ64887ZOtherBLUE SHIELDS
CAGDS004821Medicaid
CA4639500003Medicare NSC
CA314522230OtherVSP, SUPERIOR
CAP00179033Medicare ID - Type UnspecifiedRAILROAD MEDICARE