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Individual
THEO VERMONT
Active
Individual
THEO VERMONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G50840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000810823553
PHCS
CA
01
—
00G508400
BLUE SHIELD
CA
05
—
00G508400
—
CA
01
—
44556
INTERPLAN
CA
01
—
55424
GREAT WEST
CA
01
—
5979420
AETNA
CA
01
—
6420371
CIGNA
CA
01
—
90061964
PACIFICARE
CA
01
—
920643
FIRST HEALTH
CA
01
—
G50840
BLUE CROSS
CA
01
—
MCMG380400
WESTERN HEALTH ADVANTAGE
CA
Enumeration date
11/04/2006
Last updated
07/08/2007
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