Individual
AMANDA MARIE THOMETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8805 HAVEN AVE STE 200, RANCHO CUCAMONGA, CA 91730-5157
(909) 912-1750
Mailing address
4306 CAMELIA CT, CHINO, CA 91710-1602
(562) 773-9718
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA54913
CA
Other
Enumeration date
08/01/2017
Last updated
12/03/2018
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