Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G48939 | CA |
Y | 208600000X | Surgeon | G48939 | CA |
N | 2086S0102X | Surgical Critical Care | G48939 | CA |
N | 2086S0127X | Trauma Surgeon | G48939 | CA |
N | 2086S0129X | Vascular Surgeon | G48939 | CA |
NPI | 1013028521 |
---|---|
Provider Name | Dr. Thomas S Velky |
First Address | Escondido, CA 92029-1952 |
Second Address | Escondido, CA 92025-4360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A92858 | (02) | CA |