Provider Demographics
NPI:1720092653
Name:JEFFREY E. THOMAS M.D., F.A.C.S.
Entity Type:Organization
Organization Name:JEFFREY E. THOMAS M.D., F.A.C.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-923-3820
Mailing Address - Street 1:2100 WEBSTER ST
Mailing Address - Street 2:SUITE 332
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2373
Mailing Address - Country:US
Mailing Address - Phone:415-923-3820
Mailing Address - Fax:415-923-3825
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:SUITE 332
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2373
Practice Address - Country:US
Practice Address - Phone:415-923-3820
Practice Address - Fax:415-923-3825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67705208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG67705OtherCA STATE MEDICAL LICENSE
1770535072OtherJEFFREY E. THOMAS NPI
1770535072OtherJEFFREY E. THOMAS NPI
CAG67705OtherCA STATE MEDICAL LICENSE