Doctor Name: | DR. ROBERT WILLIAM TOM |
NPI Number: | 1356420996 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | C32045 |
Business Practice Address: | 23312 Madero Suite C Mission Viejo, CA - 926912738 |
Business Phone Number: | 9497075690 |
Business Fax Number: | 9497075694 |
Mailing Address: | 23312 Madero Road, Suite C MISSION VIEJO |
State: | CA |
Postal Code: | 926912732 |
Phone Number: | 9497075690 |
Fax Number: | 9497075694 |
NPI Enumeration Date: | 11/03/2006 |
NPI Last Update Date: | 06/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C32045 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |