Basic Information
| Provider Information | |||||||||
| NPI: | 1215960430 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOMKIN | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1310 COMMERCE ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | PETALUMA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949541469 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077787862 | ||||||||
| FaxNumber: | 7077780969 | ||||||||
| Practice Location | |||||||||
| Address1: | 2500 MILVIA ST | ||||||||
| Address2: | SUITE 228 | ||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947042636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105488888 | ||||||||
| FaxNumber: | 5108458313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 12/08/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | C33404 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.