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General NPI Number Information
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NPI Number | 1952325292
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Entity Type | Individual
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Provider Name | TOMAS ANTONIO MAGANA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 16335 E. 14TH ST.
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City | SAN LEANDRO
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State | CA
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Zip | 94578
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Country | US
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Telephone | 510-481-4567
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22210
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City | OAKLAND
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State | CA
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Zip | 94623-2210
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Country | US
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Telephone | 510-535-4000
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A65684
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License Number State | CA
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