Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A157266 | CA |
N | 207QA0401X | Family Doctor - Addiction Medicine | A157266 | CA |
NPI | 1760910467 |
---|---|
Provider Name | Dr. Lucia Tome |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2017 |
Last Update Date | 08/02/2022 |