Individual
SEAN R THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
208D00000X
General Practice Physician
Primary
A60305
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A603050
—
CA
01
—
A60305
LICENSE #
CA
Enumeration date
08/08/2006
Last updated
04/09/2013
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