Healthcare Provider Details

I. General information

NPI: 1972761492
Provider Name (Legal Business Name): THOMAS BERNARD OKARMA PH.D., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 05/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 CONSTITUTION DR
MENLO PARK CA
94025-1109
US

IV. Provider business mailing address

230 CONSTITUTION DR
MENLO PARK CA
94025-1109
US

V. Phone/Fax

Practice location:
  • Phone: 650-473-7785
  • Fax: 650-473-7701
Mailing address:
  • Phone: 650-473-7785
  • Fax: 650-473-7701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberG32252
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: