Fitzgerald, Thomas M

Fitzgerald, Thomas M is an sole proprietor health care provider with primary practice located at 1350 Medical Center Drive Ste B, Rohnert Park CA 94928. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Fitzgerald, Thomas M can be contacted via phone (707) 586-9300.

Contact Information

Primary practice address
1350 Medical Center Drive Ste B Rohnert Park CA 94928
Phone: (707) 586-9300
Fax: (707) 586-1252
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X E3409 California
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X E3409 California
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X E3409 California

Profile Details

NPI number 1841231834
LBN Legal business name Fitzgerald, Thomas M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2006
Last updated May 16th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841231834 NPPES
California MEDICAID 000E34090
California Other 000E34090
California Other 680159845

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