Individual
MARIAM R THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-6500
Mailing address
17435 TUSCAN DR, GRANADA HILLS, CA 91344-1056
(314) 913-3590
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A93868
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A938680
—
CA
01
—
2005029373
STATE MEDICAL LICENSE
MO
Enumeration date
02/21/2006
Last updated
07/02/2025
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