Provider Demographics
NPI:1710390729
Name:KATZ, TOMOMI (RPH)
Entity Type:Individual
Prefix:MS
First Name:TOMOMI
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 E ANATOLE ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701-2865
Mailing Address - Country:US
Mailing Address - Phone:520-488-2580
Mailing Address - Fax:
Practice Address - Street 1:4510 E 22ND ST.
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-5335
Practice Address - Country:US
Practice Address - Phone:520-807-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS019790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist