Basic Information
| Provider Information | |||||||||
| NPI: | 1972614501 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | CURT | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5525 GROSSMONT CENTER DR | ||||||||
| Address2: | |||||||||
| City: | LA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919423009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196446750 | ||||||||
| FaxNumber: | 6196441139 | ||||||||
| Practice Location | |||||||||
| Address1: | 5525 GROSSMONT CENTER DR | ||||||||
| Address2: | |||||||||
| City: | LA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919423009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196446750 | ||||||||
| FaxNumber: | 6196441139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 06/27/2013 | ||||||||
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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 | 213E00000X | E4113 | CA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213ES0103X | E4113 | CA | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
ID Information
| ID | Type | State | Issuer | Description | 000E41130 | 05 | CA | MEDICAID |