Thomas, Bradley Jonathan

Thomas, Bradley Jonathan is an sole proprietor health care provider with primary practice located at 10121 Pine Ave , Truckee CA 96161-4835. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Thomas, Bradley Jonathan can be contacted via phone (530) 587-6011.

Contact Information

Primary practice address
10121 Pine Ave Truckee CA 96161-4835
Phone: (530) 587-6011
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X G58233 California

Profile Details

NPI number 1679523617
LBN Legal business name Thomas, Bradley Jonathan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2006
Last updated Sep 16th, 2009 - about 15 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 1679523617 NPPES
California MEDICAID 00G582331

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