Individual
ROGER H THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
ONE HOAG DRIVE, NEWPORT BEACH, CA 92663-4162
(949) 764-5570
(949) 263-1639
Mailing address
DEPT LA 21555, PASADENA, CA 91185-1555
(949) 764-5570
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G21525
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G215250
BLUE SHIELD
CA
05
—
00G215250
—
CA
Enumeration date
06/16/2006
Last updated
12/12/2007
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