Individual
DR. TYLER JOSEPH THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 547-5716
Mailing address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 547-5716
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20A20365
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95171623G
—
CA
Enumeration date
06/01/2019
Last updated
11/28/2022
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