Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G072133 | CA |
NPI | 1023041662 |
---|---|
Provider Name | Dr. Thomas Tayeri |
First Address | Palo Alto, CA 94306-1162 |
Second Address | Palo Alto, CA 94306-1162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 02/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G721330 | (05) | CA |
F90629 | (02) | CA |