Healthcare Provider Details

I. General information

NPI: 1629100656
Provider Name (Legal Business Name): THOMAS L. FARLEY NP MSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE M917 BOX 0624
SAN FRANCISCO CA
94143-0624
US

IV. Provider business mailing address

505 PARNASSUS AVE M917 BOX 0624
SAN FRANCISCO CA
94143-0624
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1847
  • Fax: 415-353-1990
Mailing address:
  • Phone: 415-353-1847
  • Fax: 415-353-1990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN569767
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNPF14209
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: