Provider Demographics
NPI:1831162999
Name:O'NEIL, THOMAS C (MD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:C
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 986
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:95258-0986
Mailing Address - Country:US
Mailing Address - Phone:209-836-1155
Mailing Address - Fax:209-836-0478
Practice Address - Street 1:303 W EATON AVE
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376
Practice Address - Country:US
Practice Address - Phone:209-836-1155
Practice Address - Fax:209-836-0478
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA34142207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A341420Medicaid
A27389Medicare UPIN
CA00A341420Medicaid