Healthcare Provider Details
I. General information
NPI: 1629704333
Provider Name (Legal Business Name): TOM FINCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/26/2022
Last Update Date: 07/26/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23455 MARIPOSA AVE
TEHACHAPI CA
93561-8037
US
IV. Provider business mailing address
23455 MARIPOSA AVE
TEHACHAPI CA
93561-8037
US
V. Phone/Fax
- Phone: 661-343-2051
- Fax: 661-422-3754
- Phone: 661-343-2051
- Fax: 661-422-3754
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305S00000X |
| Taxonomy | Point of Service |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: