Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | G83600 | CA |
NPI | 1023037199 |
---|---|
Provider Name | Thomas J Lomis |
First Address | Van Nuys, CA 91405-3606 |
Second Address | Van Nuys, CA 91405-3606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G836001 | (05) | CA |
G57581 | (02) | CA |