Thomas, Mariam R

Thomas, Mariam R is an sole proprietor health care provider with primary practice located at 17435 Tuscan Dr , Granada Hills CA 91344-1056. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Thomas, Mariam R can be contacted via phone (314) 913-3590.

Contact Information

Primary practice address
17435 Tuscan Dr Granada Hills CA 91344-1056
Phone: (314) 913-3590
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A93868 California

Profile Details

NPI number 1942275250
LBN Legal business name Thomas, Mariam R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 21st, 2006
Last updated Dec 29th, 2011 - about 13 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 1942275250 NPPES
California MEDICAID 00A938680
California Other 2005029373

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