Provider Demographics
NPI:1952357741
Name:GERACI, THOMAS (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:GERACI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 BABCOCK WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1389
Mailing Address - Country:US
Mailing Address - Phone:702-480-8859
Mailing Address - Fax:
Practice Address - Street 1:1762 TECHNOLOGY DR STE 116
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-1307
Practice Address - Country:US
Practice Address - Phone:408-352-5592
Practice Address - Fax:408-453-0102
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3569208D00000X
NV767208D00000X
CA20A5373208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F24193Medicare UPIN