Individual
KEVIN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11370 ANDERSON ST, STE 2960, LOMA LINDA, CA 92354-3450
(909) 558-4094
Mailing address
PO BOX 1740, LOMA LINDA, CA 92354-0240
(909) 558-4094
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
G64070
CA
207ZP0101X
Anatomic Pathology Physician
Primary
G64070
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G640700
—
CA
Enumeration date
07/20/2006
Last updated
10/12/2011
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