Provider Demographics
NPI:1457399339
Name:ATKIN, THOMAS WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:ATKIN
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 1:634 RIVIERA CIRCLE,
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1514
Mailing Address - Country:US
Mailing Address - Phone:415-924-9484
Mailing Address - Fax:415-924-9484
Practice Address - Street 1:634 RIVIERA CIRCLE,
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1514
Practice Address - Country:US
Practice Address - Phone:415-924-9484
Practice Address - Fax:415-924-9484
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC-293671223G0001X, 2085R0202X
CAC293672085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300121760OtherRAILROAD MEDICARE
CA00C293670Medicaid
CA300035777OtherRAILROAD MEDICARE
CA300121760OtherRAILROAD MEDICARE
CA00C293671Medicare PIN
CA00C293675Medicare PIN
CA00C293672Medicare PIN
CAA33896Medicare UPIN
CA00C293670Medicare PIN
CA300035777OtherRAILROAD MEDICARE
CA00C293670Medicaid
CA00C293676Medicare PIN