Individual
PETER A THOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
405 TRAFFIC WAY, SUITE A, ARROYO GRANDE, CA 93420-3346
(805) 481-4202
(805) 481-0223
Mailing address
405 TRAFFIC WAY, SUITE A, ARROYO GRANDE, CA 93420-3346
(805) 481-4202
(805) 481-0223
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G39102
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G391020
—
CA
Enumeration date
07/11/2006
Last updated
01/26/2015
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