TAMALPAIS PEDIATRICS

5 BON AIR ROAD, STE. 105, LARKSPUR, CA, 94939

atlas:atm_npi_1073580320

What is stored

phone: 415-461-0440
status: A
address: 5 BON AIR ROAD, STE. 105, LARKSPUR, CA, 94939
fax: 415-461-3792
npi: 1073580320
taxonomy: Pediatrics
other names: []
last updated: 2015-06-03
taxonomy code: 208000000X
all taxonomies: ["Pediatrics"]
enumeration date: 2006-03-07
enumeration type: NPI-2
practice locations: 0
authorized official: NELSON BRANCO
organizational subpart: NO

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{
  "fax": "415-461-3792",
  "npi": "1073580320",
  "phone": "415-461-0440",
  "status": "A",
  "address": "5 BON AIR ROAD, STE. 105, LARKSPUR, CA, 94939",
  "license": null,
  "taxonomy": "Pediatrics",
  "other_names": [],
  "last_updated": "2015-06-03",
  "license_state": null,
  "taxonomy_code": "208000000X",
  "all_taxonomies": [
    "Pediatrics"
  ],
  "enumeration_date": "2006-03-07",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "NELSON BRANCO",
  "organizational_subpart": "NO"
}