Individual provider Active NPI

Brandon Tom, D.P.T.

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1801200399
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1162B Gorgas Ave
San Francisco, CA 94129-1406
Phone
(415) 561-6655
Fax
(415) 561-6650
NPI assigned
Jun 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1162B Gorgas Ave
San Francisco, CA 94129-1406

Mailing address

1162B Gorgas Ave
San Francisco, CA 94129-1406
Phone (415) 561-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41719CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1801200399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162B GORGAS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941291406",
            "telephone_number": "415-561-6655",
            "fax_number": "415-561-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162B GORGAS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941291406",
            "telephone_number": "415-561-6655",
            "fax_number": "415-561-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "BRANDON",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.