Active NPI
Thomas W Eastman, DO
- Gastroenterology Physician
- Fallbrook, CA
National Provider Identifier
1952381659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 20A4364
- Practice address
- 521 East Elder St
#104
Fallbrook, CA 92028 - Phone
- (760) 728-9560
- Fax
- (760) 728-9020
- NPI assigned
- Jan 19, 2006
- Last updated
- Dec 6, 2012
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 20A4364 | CA | Primary |
Addresses
Primary practice location
521 East Elder St
#104
Fallbrook, CA 92028
Mailing address
521 East Elder St
#104
Fallbrook, CA 92028
Phone (760) 728-9560
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX43640 | Other | CA | MEDICAL |
| GR0050840 | Other | CA | MEDICAL GROUP # |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A4364 | CA | MD | Gastroenterology Physician |
| 4364 | CA | MD | Acute Care Clinical Nurse Specialist |
Interoperability endpoints
- teastman181904@direct.llu.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1952381659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 EAST ELDER ST",
"address_2": "#104",
"city": "FALLBROOK",
"state": "CA",
"postal_code": "92028",
"telephone_number": "760-728-9560",
"fax_number": "760-728-9020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 EAST ELDER ST",
"address_2": "#104",
"city": "FALLBROOK",
"state": "CA",
"postal_code": "92028",
"telephone_number": "760-728-9560",
"fax_number": "760-728-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASTMAN",
"first_name": "THOMAS",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "20A4364",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "00AX43640",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL GROUP #",
"identifier": "GR0050840",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fallbrook, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.