Provider Demographics
NPI:1740358704
Name:BADIN, THOMAS (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:BADIN
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 1:801 N TUSTIN AVE
Mailing Address - Street 2:STE 703
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3611
Mailing Address - Country:US
Mailing Address - Phone:714-835-9441
Mailing Address - Fax:714-835-9442
Practice Address - Street 1:801 N TUSTIN AVE
Practice Address - Street 2:SUITE 703
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3612
Practice Address - Country:US
Practice Address - Phone:714-835-9441
Practice Address - Fax:714-835-9442
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42509207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G45209Medicare ID - Type Unspecified
A48994Medicare UPIN