Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 33807 | SC |
N | 208000000X | Pediatrician | A107618 | CA |
Y | 2080P0202X | Pediatric Cardiologist | A107618 | CA |
NPI | 1053545376 |
---|---|
Provider Name | Dr. Thomas Do |
First Address | San Diego, CA 92123 |
Second Address | San Diego, CA 92123-4223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2009 |
Last Update Date | 16/07/2015 |