Individual
DR. THEODORE S. THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4060 4TH AVE, STE 220, SAN DIEGO, CA 92103-2120
(619) 299-2350
(619) 297-8379
Mailing address
4225 EXECUTIVE SQ STE 450, LA JOLLA, CA 92037-8411
(858) 810-0000
(858) 268-1911
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G61681
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G616810
—
CA
Enumeration date
06/20/2005
Last updated
02/02/2021
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