Provider Demographics
NPI:1912279936
Name:THOMAS NEUMAN DPM PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:THOMAS NEUMAN DPM PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:661-945-3628
Mailing Address - Street 1:1672 W AVENUE J
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2827
Mailing Address - Country:US
Mailing Address - Phone:661-945-3628
Mailing Address - Fax:661-945-4497
Practice Address - Street 1:1672 W AVENUE J
Practice Address - Street 2:SUITE 201
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2827
Practice Address - Country:US
Practice Address - Phone:661-945-3628
Practice Address - Fax:661-945-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0794160002Medicare NSC