Provider Demographics
NPI:1841568425
Name:THOMAS, SCOTT P (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:P
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-340-3911
Mailing Address - Fax:760-674-3845
Practice Address - Street 1:151 S SUNRISE WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-0118
Practice Address - Country:US
Practice Address - Phone:760-834-3593
Practice Address - Fax:760-969-7781
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVDO 1799207Q00000X
CA20A11923207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1841568425Medicaid
NVV106499Medicare PIN