Healthcare Provider Details

I. General information

NPI: 1124162953
Provider Name (Legal Business Name): JILL ANN TOMAMICHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 POTRERO AVE
SAN FRANCISCO CA
94110-2869
US

IV. Provider business mailing address

887 POTRERO AVE
SAN FRANCISCO CA
94110-2869
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-4710
  • Fax: 415-206-6469
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2470A2800X
TaxonomyAssistant Health Information Record Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: