Healthcare Provider Details

I. General information

NPI: 1487676169
Provider Name (Legal Business Name): THOMAS MUSCI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DANIEL BURNHAM CT SUITE 230C
SAN FRANCISCO CA
94109-5455
US

IV. Provider business mailing address

1 DANIEL BURNHAM CT SUITE 230C
SAN FRANCISCO CA
94109-5455
US

V. Phone/Fax

Practice location:
  • Phone: 415-202-1200
  • Fax: 415-202-1201
Mailing address:
  • Phone: 415-202-1200
  • Fax: 415-202-1201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberG54938
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberG54938
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: