Basic Information
| Provider Information | |||||||||
| NPI: | 1194736637 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRUGMAN | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 168 N. BRENT STREET | ||||||||
| Address2: | SUITE 406 | ||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930032824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056536371 | ||||||||
| FaxNumber: | 8056537242 | ||||||||
| Practice Location | |||||||||
| Address1: | 168 N. BRENT STREET | ||||||||
| Address2: | SUITE 406 | ||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930032824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056536371 | ||||||||
| FaxNumber: | 8056537242 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 08/05/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | G49982 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | G49982 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.