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Organization
SEAN R THOMAS MD, INC
Active
Organization
SEAN R THOMAS MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANUARIE BAUTISA (CONTRACTS DIRECTOR)
(760) 228-3366
Entity
Organization
Contact information
Practice address
55585 29 PALMS HWY, YUCCA VALLEY, CA 92284-2505
(760) 228-3366
(760) 228-3369
Mailing address
55585 29 PALMS HWY, YUCCA VALLEY, CA 92284-2505
(760) 228-3366
(760) 228-3369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A60305
CA
208000000X
Pediatrics Physician
A60305
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089551
—
CA
Enumeration date
04/18/2007
Last updated
02/26/2015
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