Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THOMAS HATHORN
Active Sole ProprietorTHOMAS HATHORN is a Substance Abuse Rehabilitation Facility healthcare provider located in LAKESIDE, California. NPI 1093118176 is currently active in the NPPES registry. Verify at CMS.
Substance Abuse Rehabilitation Facility · LAKESIDE, CA
Registration Details
- NPI Number
- 1093118176
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 2, 2014 (11.866528319003 yrs)
- Last Updated
- Oct 2, 2014
- License
-
370139AN (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
24352 FEATHERSTONE CANYON RD.LAKESIDE, CA, 92040Browse CA providers · Browse ZIP 92040
- Phone
- 6197977319
- Primary Specialty
-
Substance Abuse Rehabilitation Facility
324500000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.