Eloise Thacker, C70773

NPI 1730914458 · on the registry since 2024 · sole proprietor

Practice

Address: 355 E 21st St
San Bernardino, CA 92404
Phone: (909) 882-0193
Fax: (909) 883-4834
Organisation at this address: C Damirchi M D Inc
Bedside Medical Inc
Pharmacy Service Inc
Banipal Medical Corp
Beemans Boutique Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 16

Registry record

Primary taxonomy: 332B00000X
332B00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2024-09-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California