Provider Information for 1336401561
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LORI P MONTROSS THOMAS PhD
Sex: Female
NPI: 1336401561
Last Updated: 2014-01-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1336401561 | ||||||||||||
| Enumeration Date | 2012-06-13 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 9500 GILMAN DR DEPT 664 UNIVERSITY OF CALIFORNIA SAN DIEGO LA JOLLA, CA 92093-0664 United States Phone: 619-206-9962 | Fax: | ||||||||||||
| Primary Practice Address | 9500 GILMAN DR DEPT 664 UNIVERSITY OF CALIFORNIA SAN DIEGO LA JOLLA, CA 92093-0664 United States Phone: 619-206-9962 | Fax: | ||||||||||||
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