MEDICARE: JULIA J TOM

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	183500000X	Pharmacist	47265	CA

General Provider Information

NPI Number	:	1972591659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA J TOM

Provider Business Mailing Address
First Line	:	617 MORSE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94112-4221
Country	:	US
Telephone Number	:	415-606-9978
Fax Number	:

Provider Business Practice Location Address
First Line	:	617 MORSE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94112-4221
Country	:	US
Telephone Number	:	415-606-9978
Fax Number	:

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	07/08/2007

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Directions to “ JULIA J TOM ” Practice Location

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