Healthcare Provider Details

I. General information

NPI: 1144201625
Provider Name (Legal Business Name): THOMAS GEOGHEGAN WEISER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
PALO ALTO CA
94304-2203
US

IV. Provider business mailing address

300 PASTEUR DR
PALO ALTO CA
94304-2203
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-4000
  • Fax:
Mailing address:
  • Phone: 650-723-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA84864
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA84864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: