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NPI Code Detail

MEDICARE: TOM R NORRIS M D A PROFESSIONAL CORP

MEDICARE: TOM R NORRIS M D A PROFESSIONAL CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianG215690CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G21569OTHERCALICENSE NUMER

General Provider Information

NPI Number : 1205824638
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOM R NORRIS M D A PROFESSIONAL CORP
Provider Business Mailing Address
First Line : 2351 CLAY ST
Second Line : STE 510
City : SAN FRANCISCO
State : CA
Zip : 94115-1931
Country : US
Telephone Number : 415-392-3225
Fax Number : 415-928-1035
Provider Business Practice Location Address
First Line : 2351 CLAY ST
Second Line : STE 510
City : SAN FRANCISCO
State : CA
Zip : 94115-1931
Country : US
Telephone Number : 415-392-3225
Fax Number : 415-928-1035
Authorized Official
Title or Position : PRESIDENT
Name : TOM RANDOLPH NORRIS
Credential : MD
Telephone Number : 415-392-3225
Provider Enumeration Date : 10/10/2005
Last Update Date : 11/13/2009

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Directions to “TOM R NORRIS M D A PROFESSIONAL CORP ” Practice Location

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