Individual
EITAN HOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
165 LYNCH CREEK WAY, PETALUMA, CA 94954-2343
(707) 762-5531
(707) 762-5976
Mailing address
500 ALFRED NOBEL DR, SUITE 245, HERCULES, CA 94547-1838
(510) 741-7299
(510) 741-7493
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070012651
MEDICARE RAILROAD
CA
01
—
A64754
LICENSE NUMBER
CA
Enumeration date
10/19/2006
Last updated
03/05/2015
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