Provider Demographics
NPI:1780060566
Name:TOPHAM, FARRELL
Entity type:Individual
Prefix:
First Name:FARRELL
Middle Name:
Last Name:TOPHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 FAIR OAKS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3616
Mailing Address - Country:US
Mailing Address - Phone:415-509-6300
Mailing Address - Fax:
Practice Address - Street 1:367 FAIR OAKS ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3616
Practice Address - Country:US
Practice Address - Phone:415-509-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN