Provider Demographics
NPI:1104145671
Name:THOMPSON, TOMMY RALPH (PHARMD BCNP)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:RALPH
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:PHARMD BCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1828 TRIBUTE RD
Mailing Address - Street 2:SUITE A-E
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4310
Mailing Address - Country:US
Mailing Address - Phone:916-648-3334
Mailing Address - Fax:916-648-3339
Practice Address - Street 1:4004 FOOTHILLS
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747
Practice Address - Country:US
Practice Address - Phone:916-786-8671
Practice Address - Fax:916-786-0399
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA535651835N0905X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclear
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist