Provider Demographics
NPI:1700462827
Name:THOMAS P. ANKER, DO., INC.
Entity Type:Organization
Organization Name:THOMAS P. ANKER, DO., INC.
Other - Org Name:OMIC WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:ANKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-975-4742
Mailing Address - Street 1:2930 FREEPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-3843
Mailing Address - Country:US
Mailing Address - Phone:888-773-0339
Mailing Address - Fax:
Practice Address - Street 1:2930 FREEPORT BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-3843
Practice Address - Country:US
Practice Address - Phone:888-773-0339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty