Individual
DR. TOMI LEE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3300 WEBSTER ST, SUITE 1106, OAKLAND, CA 94609-3117
(510) 763-2662
(510) 601-0750
Mailing address
3300 WEBSTER ST STE 1106, OAKLAND, CA 94609-3125
(510) 763-2662
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A97586
CA
207NS0135X
Procedural Dermatology Physician
A97586
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
462225
TUFTS HEALTH PLAN
MA
01
—
J29028
BCBS MA
MA
Enumeration date
10/25/2005
Last updated
07/11/2007
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