Individual
DIANE LESLIE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
12550 HESPERIA ROAD, SUITE 100, VICTORVILLE, CA 92395-0000
(760) 241-6666
(760) 241-7575
Mailing address
17095 MAIN ST, HESPERIA, CA 92345-0000
(760) 241-6666
(760) 241-7575
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA19605
CA
Other
Enumeration date
07/10/2009
Last updated
10/10/2013
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