Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A81778 | CA |
N | 111NI0900X | Internist | A81778 | CA |
Y | 207RC0200X | Critical Care Medicine | A81778 | CA |
N | 207RP1001X | Pulmonary Disease | A81778 | CA |
NPI | 1003892233 |
---|---|
Provider Name | Dr. Michael John Thornton |
First Address | Sacramento, CA 95817-1460 |
Second Address | Sacramento, CA 95817-1460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 09/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H83502 | (02) | CA |