Individual
RONALD W THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 829-8913
(310) 315-6168
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
(626) 775-3514
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G12376
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G123760
—
CA
01
—
00G123761
MEDICARE TEM
CA
01
—
00G123762
MEDICARE SBMC
CA
01
—
G12376
MEDICAL LICENSE
CA
01
—
WG12376C
MEDICARE VROC
CA
01
—
WG12376F
MEDICARE SJHC
CA
01
—
WG12376G
MEDICARE - SJMC
CA
01
—
WG12376I
MEDICARE LCM
CA
01
—
WG12376J
MEDICARE SAN PEDRO
CA
01
—
WG12376K
MEDICARE EL CEN
CA
Enumeration date
12/09/2005
Last updated
11/16/2020
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