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General NPI Number Information
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NPI Number | 1841015575
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Entity Type | Organization
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Legal Business Name | GENOMAI LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 104 GERBERA STREET (OPTIONAL)
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City | DANVILLE
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State | CA
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Zip | 94506-4790
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Country | US
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Telephone | 503-709-5519
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Fax |
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Provider Business Mailing Address
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Address Line | 104 GERBERA STREET (OPTIONAL)
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City | DANVILLE
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State | CA
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Zip | 94506-4790
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Country | US
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Telephone | 503-709-5519
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MARIA NOEMI PEREZ PAZ
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Credential |
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Telephone | 503-709-5519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0203X
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Taxonomy Name | Clinical Molecular Genetics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number |
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License Number State |
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