Aesthetic Laser & Vein Center of the North Bay

Primary specialty

SpecialistTaxonomy code 174400000X

License

657374 Issued in CA

Legal business name

AESTHETIC LASER & VEIN CENTER OF THE NORTH BAY

Practice address

170 Farmers LN Ste 6B
Santa Rosa, CA 95405-4768

Phone

(707) 542-8346

NPI assigned

Feb 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Walter W. Tom, M.D.NPI 1861414179

Title

Doctor

Phone

(707) 542-8346

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Walter W Tom, MD, FACS

  • Specialist
  • Santa Rosa, CA
  • NPI 1861414179
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508992199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 FARMERS LN STE 6B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 FARMERS LN STE 6B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054768",
            "telephone_number": "707-542-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC LASER & VEIN CENTER OF THE NORTH BAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TOM",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "707-542-8346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "657374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adventist Health Physicians Network
• Adventist Health Physicians Network
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• Arianne Renee Advocate, MA, MFTI
• Ty Preston Affleck, MD
• Affordable Homecare Associates LLC
• Tina Page Afifi, HA7576
• Agape Clinic With Heart: a Professional Nursing Organization
• Jamie Dawn Agapoff, M.D.

• Specialist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.