Jeremy Thacker

NPI 1508661794 · on the registry since 2025 · sole proprietor

Practice

Address: 11712 Moorpark St Ste 204b
Studio City, CA 91604
Phone: (323) 834-2420
Organisation at this address: Centralmed Inc
Nicole Mevorak
S&M Hospice Inc
Bryce Mcdavitt Phd
Selective Hospice Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 48

Registry record

Primary taxonomy: 103TC0700X
103TC0700X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-02-13

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