Provider Demographics
NPI:1356336101
Name:GEORGE P THOMAS MD INC
Entity type:Organization
Organization Name:GEORGE P THOMAS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:P
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-447-0782
Mailing Address - Street 1:622 W DUARTE RD
Mailing Address - Street 2:STE 302
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9278
Mailing Address - Country:US
Mailing Address - Phone:626-447-0782
Mailing Address - Fax:626-447-0795
Practice Address - Street 1:622 W DUARTE RD
Practice Address - Street 2:STE 302
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9278
Practice Address - Country:US
Practice Address - Phone:626-447-0782
Practice Address - Fax:626-447-0795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35801207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A358011Medicaid
CA00A358011Medicaid
CAA35801Medicare ID - Type Unspecified