Individual
DOUGLAS TOM IMURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 CYPRESS AVE, SOUTH SAN FRANCISCO, CA 94080-2922
(650) 380-6149
(650) 952-5846
Mailing address
300 HARBOR BLVD BLDG E, BELMONT, CA 94002-4018
(650) 380-6149
(650) 952-5846
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/02/2017
Last updated
06/02/2017
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