Basic Information
| Provider Information | |||||||||
| NPI: | 1124186085 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FARNHAM | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1145 MARKET ST FL 10 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941031566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155527914 | ||||||||
| FaxNumber: | 4155523455 | ||||||||
| Practice Location | |||||||||
| Address1: | 1701 ZONAL AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900331065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232236298 | ||||||||
| FaxNumber: | 3232236399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 03/13/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G042378 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207QA0401X | G042378 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QG0300X | G042378 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
No ID Information.