Provider Demographics
NPI:1124169388
Name:THOMAS E. MCKNIGHT JR DO MPH INC
Entity type:Organization
Organization Name:THOMAS E. MCKNIGHT JR DO MPH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO MPH
Authorized Official - Phone:530-896-0260
Mailing Address - Street 1:236 W EAST AVE
Mailing Address - Street 2:PMB 104
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7235
Mailing Address - Country:US
Mailing Address - Phone:530-896-0260
Mailing Address - Fax:530-896-0287
Practice Address - Street 1:130 INDEPENDENCE CIR
Practice Address - Street 2:SUITE 5
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4962
Practice Address - Country:US
Practice Address - Phone:530-896-0260
Practice Address - Fax:530-896-0287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4876207R00000X, 204D00000X, 2084N0400X, 2084N0600X, 2084S0012X, 2083P0901X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX48760Medicaid
CADO9225OtherMEDICARE RAILROAD #
CAC32631Medicare UPIN
CA020A48760Medicare PIN