Provider Demographics
NPI:1780912683
Name:THOMAS, JAMES DONALD (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DONALD
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:178 N OAK KNOLL AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1800
Mailing Address - Country:US
Mailing Address - Phone:626-696-3991
Mailing Address - Fax:
Practice Address - Street 1:9900 BALBOA BLVD STE E
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-5419
Practice Address - Country:US
Practice Address - Phone:818-701-0017
Practice Address - Fax:818-701-0073
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG21216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine