Joseph C Tholmer, CASI

Individual provider Active NPI Specialist · Lotus, CA

NPI 1649415332 · NPPES record last updated Dec 9, 2008

Key facts

NPI
1649415332
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
9041 (CA)
Practice address
838 Beach Court
Lotus, CA 95614
Phone
(916) 628-9813
NPI assigned
Dec 9, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9041CAMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9041 CA Yes

Addresses

Primary practice location

838 Beach Court
Lotus, CA 95614

Mailing address

PO Box 437
Coloma, CA 95613-0437
Phone (916) 628-9813

Other identifiers

IdentifierTypeStateIssuer
9041OtherCACAARR

Other providers in Lotus, CA

All providers in Lotus, CA · Specialist in California

Sources for this page

Verify at the official NPI Registry.