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General NPI Number Information
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NPI Number | 1376802579
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Entity Type | Organization
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Legal Business Name | THOMAS R POWERS MD. INC
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 20055 LAKE CHABOT RD SUITE 350
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5331
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Country | US
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Telephone | 510-889-0422
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Fax | 510-538-8343
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Provider Business Mailing Address
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Address Line | 20055 LAKE CHABOT RD SUITE 350
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5331
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Country | US
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Telephone | 510-889-0422
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Fax | 510-538-8343
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Authorized Official
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Title or Position | PSYCHIATRY
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Name | DR. THOMAS ROBERT POWERS
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Credential |
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Telephone | 510-889-0422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | G23847
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License Number State | CA
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