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General NPI Number Information
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NPI Number | 1447271382
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Entity Type | Individual
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Provider Name | THOMAS PENMAN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 4820 N 1ST ST STE 104
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City | FRESNO
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State | CA
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Zip | 93726-0522
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Country | US
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Telephone | 559-226-5860
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Fax | 559-224-3969
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Provider Business Mailing Address
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Address Line | 7058 N WEST AVE # 175
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City | FRESNO
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State | CA
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Zip | 93711-0462
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Country | US
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Telephone | 559-708-7928
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 000E21961
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License Number State | CA
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