THOMAS MICHAEL DOUGHERTY (NPI# 1699712232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699712232 |
| Entity Type | Individual |
| Full Name | THOMAS MICHAEL DOUGHERTY |
| Credential | M.D. |
| Practice Address |
15627 Imperial Hwy La Mirada CA 90638-1627 |
| Practice Telephone | 7149900911 |
| Practice Fax Number | 7142569172 |
| Mailing Telephone | 7149900911 |
| Mailing Fax Number | 7142569172 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2015-03-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G27977 | CA | Allopathic & Osteopathic Physicians |
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
G27977 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE SHIELD ID # | 00G279770 | 01 | |
| RAILROAD | 110060919 | 01 | |
| CA | 00G279770 | 05 | |
| HEALTH NET ID # | 023927 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952403651 | Thomas M Dougherty | Emergency Medicine | 1019 Skinker Pkwy, 156, Saint Louis, MO 63112-2355 | 2006-09-02 |
| 1578587382 | Thomas Roy Dougherty | Dentist | 618 W Main St Ste E-101, League City, TX 77573-3773 | 2006-07-26 |
| 1356978449 | Thomas Michael Dougherty Jr. | Student in an Organized Health Care Education/Training Program | 703 N Flamingo Rd, Pembroke Pines, FL 33028-1006 | 2020-03-26 |
| 1831514967 | Thomas Francis Dougherty Jr. | Counselor | 189 Market St, Kingston, PA 18704-5400 | 2014-02-26 |
| 1982036018 | Thomas E Dougherty IIi | Social Worker | 2000 Bremo Rd, Suite 105, Richmond, VA 23226-2440 | 2013-07-31 |
| 1174814123 | Thomas E Dougherty Jr. | Counselor | 514 S Stratford Rd, Ste 306, Winston Salem, NC 27103-1823 | 2011-04-26 |
| 1497056873 | Thomas Michael Dougherty Sr. | Psychologist | 12605 East Fwy, Houston, TX 77015-5625 | 2010-11-16 |
| 1902082621 | Thomas Dougherty | Physical Therapy Assistant | 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 | 2008-01-11 |
| 1558553248 | Thomas C Dougherty | Nurse Practitioner | 2139 Auburn Ave, Cincinnati, OH 45219-2906 | 2007-08-16 |
| 1043374515 | Thomas Patrick Dougherty | Dentist | 5317 Limestone Rd, Wilmington, DE 19808-1252 | 2006-12-20 |
| Street Address |
15627 IMPERIAL HWY |
| City | LA MIRADA |
| State | CA |
| Zip Code | 90638-1627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437196730 | Richard F. Mc Guire | Internal Medicine | 15627 Imperial Hwy, La Mirada, CA 90638-1627 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972144095 | Amanda Connell | Counselor | 13710 La Mirada Blvd., Straight Talk, La Mirada, CA 90638 | 2019-09-30 |
| 1679054894 | James Kim | Occupational Therapist | 11926 La Mirada Blvd., La Mirada, CA 90638 | 2018-08-25 |
| 1780163915 | Complete Spine and Joint Center Inc | Chiropractor | 15112 Rosecrans Ave, La Mirada, CA 90638 | 2018-08-08 |
| 1124520606 | Meredith Narcisse | Counselor | Aegis Treatment Center 14240 Imperial Hwy, La Mirida, CA 90638 | 2018-03-01 |
| 1336685114 | Dorina Hamilton | Counselor | 14240 E. Imperial Hwy., La Mirada, CA 90638 | 2017-01-17 |
| 1497201768 | Blm Pharmacy Inc | Pharmacy | 12675 La Mirada Blvd., Suite 100, La Mirada, CA 90638 | 2016-08-28 |
| 1972954535 | Wendy Tran | Dentist | 12265 La Mirada Blvd, La Mirada, CA 90638 | 2016-06-24 |
| 1962851410 | Amy Bender | Counselor | 14240 Imperial Highway, La Mirada, CA 90638 | 2016-06-06 |
| 1699137430 | Andrea Lauren Smith | Chiropractor | 15651 East Imperial Hwy Ste 100, La Mirada, CA 90638 | 2016-03-22 |
| 1750797098 | Napoleon Tiquia | General Practice | 12049 Hartdale Avenue, La Mirada, CA 90638 | 2014-07-08 |
| Find all providers in zip 90638 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053326793 | Mohammed Khursheed | Internal Medicine | 15034 Imperial Hwy, La Mirada, CA 90638-1301 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962000141 | Suman S Kuppahally, M.d. Inc | Internal Medicine | 2505 Samaritan Dr Ste 600, San Jose, CA 95124-4017 | 2020-10-11 |
| 1336754472 | Ankur Gupta Medical Corporation | Internal Medicine | 820 S Akers St Ste 130, Visalia, CA 93277-8346 | 2020-09-15 |
| 1295351740 | Penciu Medical Apmc | Internal Medicine | 1585 Sierra Madre Villa Ave, Pasadena, CA 91107-1259 | 2020-06-21 |
| 1679113336 | La Pulse Medical, Inc | Internal Medicine | 14558 Sylvan St Ste 105, Van Nuys, CA 91411-2324 | 2020-01-10 |
| 1770122871 | John R. Nelson M.d. Inc. | Internal Medicine | 7061 N Whitney Ave Ste 101, Fresno, CA 93720-8025 | 2020-01-06 |
| 1730725789 | Norcal Medical Services, Inc | Internal Medicine | 2267 Lava Ridge Ct, Roseville, CA 95661-3062 | 2019-11-25 |
| 1932750957 | Enloe Medical Center | Internal Medicine | 1430 Esplanade Ste 6, Chico, CA 95926-3366 | 2019-09-20 |
| 1528610425 | Nicholas Russell | Internal Medicine | 2967 N Moorpark Rd, Thousand Oaks, CA 91360-4573 | 2019-07-10 |
| 1043871627 | Gy Medical Clinic Inc | Internal Medicine | 7400 Van Nuys Blvd Ste 112, Van Nuys, CA 91405-1972 | 2019-06-25 |
| 1902465792 | Pacific Heart & Vascular | Internal Medicine | 1234 W. Chapman Ave, Ste #101, Orange, CA 92868-2862 | 2019-06-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.