Basic Information
| Provider Information | |||||||||
| NPI: | 1205587771 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMER | ||||||||
| FirstName: | CARIN | ||||||||
| MiddleName: | IRENE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12362 GEORGIAN ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928413026 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1775 CHESTNUT AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908131674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625998444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2022 | ||||||||
| LastUpdateDate: | 01/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | 683057 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.