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General NPI Number Information
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NPI Number | 1780856427
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Entity Type | Individual
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Provider Name | JEFFREY JAMES HOM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 505 PARNASSUS AVE UCSF DEPARTMENT OF RADIOLOGY, M-391, BOX 0628
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2204
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Country | US
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Telephone | 415-443-0579
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Fax |
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Provider Business Mailing Address
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Address Line | 300 PASTEUR DR DEPARTMENT OF RADIOLOGY, SHS H1307
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City | STANFORD
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State | CA
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Zip | 94305-2200
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Country | US
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Telephone |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A102859
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License Number State | CA
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