Active NPI
Charles Connor Thornton
- Specialist
- San Diego, CA
National Provider Identifier
1225716590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 861 6TH Ave. Suite 860
San Diego, CA 92101 - Phone
- (619) 940-7577
- Fax
- (619) 923-5299
- NPI assigned
- Jul 7, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
861 6TH Ave. Suite 860
San Diego, CA 92101
Mailing address
4680 Laser Rd
Shelby, OH 44875-9318
Phone (419) 566-4009
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thornton Pacific Laboratories | Current | Accepting new patients |
Locations
861 6th Ave
Ste 860
San Diego, CA 92101
Phone (619) 940-7577
Organizations & group practices 1
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.
-
- Clinical Medical Laboratory
- San Diego, CA
- NPI 1447938816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688688000000",
"number": "1225716590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4680 LASER RD",
"city": "SHELBY",
"state": "OH",
"postal_code": "448759318",
"telephone_number": "419-566-4009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "861 6TH AVE. SUITE 860",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92101",
"telephone_number": "619-940-7577",
"fax_number": "619-923-5299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORNTON",
"first_name": "CHARLES",
"middle_name": "CONNOR",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-07",
"last_updated": "2023-07-07",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.