Individual
DR. THOMAS KEITH MOGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11955 PENDLETON RD, YUCAIPA, CA 92399-4029
(909) 790-1910
Mailing address
11955 PENDLETON RD, YUCAIPA, CA 92399-4029
(909) 790-1910
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
G079090
CA
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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