Individual
DR. JOHN A. THORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9001
(619) 543-7874
Mailing address
200 W ARBOR DR, SAN DIEGO, CA 92103-9001
(619) 543-7874
Taxonomy
Speciality
Code
Description
License number
State
207SM0001X
Molecular Genetic Pathology (Medical Genetics) Physician
A82079
CA
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
2006023097
MO
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
4301081249
MI
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
2006023097
MO
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
4301081249
MI
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
A82079
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
# PENDING
—
MO
05
—
4544083
—
MI
Enumeration date
09/28/2006
Last updated
02/12/2009
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