Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A60923 | CA |
NPI | 1124057930 |
---|---|
Provider Name | Dr. Tina Louise Molumphy |
First Address | Los Altos, CA 94024-5620 |
Second Address | Los Altos, CA 94024-5698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 22/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H01927 | (02) | CA |