Active NPI
Thomas James Wicks, M.D
- Emergency Medicine Physician
- Laguna Hills, CA
National Provider Identifier
1609803196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- G28357
- Practice address
- 24451 Health Center Dr
Laguna Hills, CA 92653-3689 - Phone
- (714) 837-4500
- NPI assigned
- Jun 28, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G28357 | CA | Primary |
Addresses
Primary practice location
24451 Health Center Dr
Laguna Hills, CA 92653-3689
Mailing address
2100 Powell Street
Ste 920
Emeryville, CA 94608
Phone (510) 350-2777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A234300 | 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 Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202256000000",
"number": "1609803196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL STREET",
"address_2": "STE 920",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "94608",
"telephone_number": "510-350-2777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24451 HEALTH CENTER DR",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926533689",
"telephone_number": "714-837-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKS",
"first_name": "THOMAS",
"middle_name": "JAMES",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2008-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "G28357",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A234300",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Laguna Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.