Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | D5819 | AZ |
N | 1223G0001X | General Practice | 5819 | AZ |
N | 213EG0000X | General Practice | 5819 | AZ |
NPI | 1972678704 |
---|---|
Provider Name | Dr. Donald Tune Hom |
First Address | Scottsdale, AZ 85254-5019 |
Second Address | Mesa, AZ 85210-5030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 30/06/2016 |