Individual
BERT J. THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 202-6204
(310) 202-0831
Mailing address
15332 ANTIOCH ST # 105, PACIFIC PALISADES, CA 90272-3603
(310) 202-6204
(310) 202-0831
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
G43282
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G432820
—
CA
Enumeration date
09/17/2006
Last updated
07/08/2008
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