1174670012 NPI number — MARIA JOSEPHINA TRAN GOMEZ FNP

Table of content: MARIA JOSEPHINA TRAN GOMEZ FNP (NPI 1174670012)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174670012 NPI number — MARIA JOSEPHINA TRAN GOMEZ FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOMEZ
Provider First Name:
MARIA JOSEPHINA
Provider Middle Name:
TRAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOMEZ
Provider Other First Name:
JOSEPHINA
Provider Other Middle Name:
TRAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1174670012
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 PASTEUR DRIVE, STANFORD HOSPITAL AND CLINICS
Provider Second Line Business Mailing Address:
DIGESTIVE HEALTH CENTER, BLAKE WILBUR BUILDING
Provider Business Mailing Address City Name:
PALO ALTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-736-5555
Provider Business Mailing Address Fax Number:
650-723-8378

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 PASTEUR DRIVE, STANFORD HOSPITAL AND CLINICS
Provider Second Line Business Practice Location Address:
DIGESTIVE HEALTH CENTER, BLAKE WILBUR BUILDING
Provider Business Practice Location Address City Name:
PALO ALTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-736-5555
Provider Business Practice Location Address Fax Number:
650-723-8378
Provider Enumeration Date:
01/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  NP12784 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: 443865 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)