1902871049 NPI number — JANICE TOMITA PT & ASSOCIATES

Table of content: (NPI 1902871049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902871049 NPI number — JANICE TOMITA PT & ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JANICE TOMITA PT & ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902871049
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
591 REDWOOD HWY
Provider Second Line Business Mailing Address:
#5260
Provider Business Mailing Address City Name:
MILL VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94941
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-381-0541
Provider Business Mailing Address Fax Number:
415-381-0591

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
591 REDWOOD HWY
Provider Second Line Business Practice Location Address:
#5260
Provider Business Practice Location Address City Name:
MILL VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94941-6033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-381-0541
Provider Business Practice Location Address Fax Number:
415-381-0591
Provider Enumeration Date:
02/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOMITA
Authorized Official First Name:
JANICE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
415-381-0541

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  00PT97250 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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