Individual
THAD VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 EL CAMINO REAL, SOUTH SAN FRANCISCO, CA 94080-3208
(650) 742-2000
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3466
(510) 625-6262
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A161158
CA
Other
Enumeration date
03/28/2017
Last updated
08/08/2023
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