Provider Demographics
NPI:1689741779
Name:HOM, JOANNE AMY (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:AMY
Last Name:HOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 CALIFORNIA ST
Mailing Address - Street 2:316
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1522
Mailing Address - Country:US
Mailing Address - Phone:415-379-9600
Mailing Address - Fax:415-379-9823
Practice Address - Street 1:3838 CALIFORNIA ST
Practice Address - Street 2:316
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1522
Practice Address - Country:US
Practice Address - Phone:415-379-9600
Practice Address - Fax:415-379-9823
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46104207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA50287Medicare UPIN
CA00A61750Medicare ID - Type Unspecified