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Individual
THOMAS C CARMODY
Active
Individual
THOMAS C CARMODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.,C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OPA137830
CA
363AM0700X
Medical Physician Assistant
OPA137830
CA
363AS0400X
Surgical Physician Assistant
OPA137830
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170865900
US DEPT OF LABOR
CA
05
—
GR0064540
—
CA
01
—
P00165306
RAILROAD MEDICARE
CA
01
—
ZZZ00355Z
BLUE SHIELD OF CALIF.
CA
Enumeration date
08/23/2006
Last updated
03/02/2016
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