Provider Demographics
NPI:1326130071
Name:HOM, FRED B (MD MS)
Entity Type:Individual
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First Name:FRED
Middle Name:B
Last Name:HOM
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Gender:M
Credentials:MD MS
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Mailing Address - Street 1:907 HYDE STREET
Mailing Address - Street 2:SUITE 508
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109
Mailing Address - Country:US
Mailing Address - Phone:415-922-8080
Mailing Address - Fax:415-474-9288
Practice Address - Street 1:907 HYDE STREET
Practice Address - Street 2:SUITE 508
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109
Practice Address - Country:US
Practice Address - Phone:415-922-8080
Practice Address - Fax:415-474-9288
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG50415207RP1001X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A51672Medicare UPIN