Provider Demographics
NPI:1982803607
Name:THOMAS, RONALD ARON
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ARON
Last Name:THOMAS
Suffix:
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 1:2730 ADELINE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-2408
Mailing Address - Country:US
Mailing Address - Phone:510-446-7157
Mailing Address - Fax:510-338-6715
Practice Address - Street 1:2730 ADELINE ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-2408
Practice Address - Country:US
Practice Address - Phone:510-446-7157
Practice Address - Fax:510-338-6715
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA943007538OtherAARS