Active NPI
Stephen W. Thacker, D.O.
- Family Medicine Physician
- Brea, CA
National Provider Identifier
1003854274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A5071
- Practice address
- 340 W Central Ave Ste 110
Attention: Maggie Noles
Brea, CA 92821-3006 - Phone
- (714) 529-3971
- Fax
- (714) 529-1070
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A5071 | CA | Primary |
Addresses
Primary practice location
340 W Central Ave Ste 110
Attention: Maggie Noles
Brea, CA 92821-3006
Mailing address
PO Box 51238
Attention: Maggie Noles
Los Angeles, CA 90051-5538
Phone (562) 741-4461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX50710 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caremore Medical Group | Family Medicine | Past | Accepting new patients |
| Caremore Medical Group Inc | Family Medicine | Past | Accepting new patients |
| Queen of the Valley Medical Association | Past | Accepting new patients | |
| Rubin and McNamara MDS Inc | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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Family Medicine
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- NPI 1760435705
-
- Gynecology Physician
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- NPI 1649260126
-
- Hematology & Oncology Physician
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- NPI 1659328219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1003854274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 51238",
"address_2": "ATTENTION: MAGGIE NOLES",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900515538",
"telephone_number": "562-741-4461",
"fax_number": "562-741-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 W CENTRAL AVE STE 110",
"address_2": "ATTENTION: MAGGIE NOLES",
"city": "BREA",
"state": "CA",
"postal_code": "928213006",
"telephone_number": "714-529-3971",
"fax_number": "714-529-1070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACKER",
"first_name": "STEPHEN",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A5071",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX50710",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.