Healthcare Provider Details

I. General information

NPI: 1982905006
Provider Name (Legal Business Name): ALTOMED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2010
Last Update Date: 04/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 SOUTH DR STE 4
MOUNTAIN VIEW CA
94040-4207
US

IV. Provider business mailing address

305 SOUTH DR STE 4
MOUNTAIN VIEW CA
94040-4207
US

V. Phone/Fax

Practice location:
  • Phone: 650-861-6110
  • Fax:
Mailing address:
  • Phone: 650-861-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number59894
License Number StateCA

VIII. Authorized Official

Name: HOMA TABATABAIE ADNANI
Title or Position: OFFICER
Credential:
Phone: 650-861-6110