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Individual

THOMAS PORTER WHETZEL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2315 STOCKTON BLVD, DEPARTMENT OF SURGERY, SACRAMENTO, CA 95817-2201
(916) 734-2568
Mailing address
2315 STOCKTON BLVD, DEPARTMENT OF SURGERY, SACRAMENTO, CA 95817-2201
(916) 734-2568

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
G057560
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GR002104R
MEDI-CAL
CA
Enumeration date
11/16/2005
Last updated
07/08/2007
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