Provider Demographics
NPI:1992807689
Name:THOMAS, CLARE ANNE (DO)
Entity type:Individual
Prefix:DR
First Name:CLARE
Middle Name:ANNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 23RD ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1725
Mailing Address - Country:US
Mailing Address - Phone:310-399-2144
Mailing Address - Fax:
Practice Address - Street 1:2235 23RD ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-1725
Practice Address - Country:US
Practice Address - Phone:310-399-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 8684207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5524806Medicaid
NJ5524806Medicaid
NJTH746603Medicare ID - Type UnspecifiedMEDICARE PROVIDER #