Organization
SEAN R THOMAS MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANUARIE BAUTISTA BS (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
—
—
261QR1300X
Rural Health Clinic/Center
Primary
A603050
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM53886G
—
CA
Enumeration date
04/16/2007
Last updated
02/26/2015
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