Provider Demographics
NPI:1205951134
Name:GATYAS, THOMAS PETER (MA)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PETER
Last Name:GATYAS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11660 MAYFIELD AVE
Mailing Address - Street 2:#204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5757
Mailing Address - Country:US
Mailing Address - Phone:310-488-8268
Mailing Address - Fax:
Practice Address - Street 1:13130 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-6037
Practice Address - Country:US
Practice Address - Phone:818-947-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program