Provider Demographics
NPI:1932844768
Name:THOMASSON, MICHEAL SEAN II
Entity Type:Individual
Prefix:MR
First Name:MICHEAL
Middle Name:SEAN
Last Name:THOMASSON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 TRUXTUN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0624
Mailing Address - Country:US
Mailing Address - Phone:661-281-2711
Mailing Address - Fax:
Practice Address - Street 1:5601 TRUXTUN AVE STE 150
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0624
Practice Address - Country:US
Practice Address - Phone:661-281-2711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1350032279P3900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/Pediatrics