Individual
BRIAN MICHAEL THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A-C
Contact information
Practice address
1441 FLORIDA AVENUE, MODESTO, CA 95350
(209) 576-3609
Mailing address
2100 POWELL STREET, STE. 920, EMERYVILLE, CA 94608-1803
(510) 350-2777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14983
CA
Other
Enumeration date
06/02/2006
Last updated
01/25/2008
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