MEDICARE: THOMAS P TWADDELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	CFE28737	CA

General Provider Information

NPI Number	:	1760751176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS P TWADDELL M.D.

Provider Business Mailing Address
First Line	:	600 DUNCAN ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-1841
Country	:	US
Telephone Number	:	415-206-9293
Fax Number	:	415-206-9293

Provider Business Practice Location Address
First Line	:	600 DUNCAN ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-1841
Country	:	US
Telephone Number	:	415-206-9293
Fax Number	:	415-206-9293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2011
Last Update Date	:	02/28/2013

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