Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | G21635 | CA |
NPI | 1053320234 |
---|---|
Provider Name | Tommy J. Poirier |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Sacramento, CA 95816-7058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 13/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000001230694 | PHCS (01) | CA |
0006685 | CIGNA (01) | CA |
00G216350 | (05) | CA |
013520 | HEALTH NET (01) | CA |
1090747 | GREAT WEST (01) | CA |
11720 | FIRST HEALTH (01) | CA |
15147 | INTERPLAN (01) | CA |
259062 | UNITED HEALTHCARE (01) | CA |
4054884 | AETNA (01) | CA |
90019023 | PACIFICARE (01) | CA |
A49478 | (02) | |
G21635 | BLUE CROSS (01) | CA |
MCMG157200 | WESTERN HEALTH ADVANTAGE (01) | CA |