Organization
J. TALISMAN POMEROY, IV, M.D.
Active
Other names
J. Talisman Pomeroy, IV, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
MARLYN TASHIRO (MEDICAL BILLER)
(831) 462-8755
Entity
Organization
Contact information
Practice address
3035 N MAIN ST, SOQUEL, CA 95073-2204
(831) 462-8750
(831) 475-5713
Mailing address
3035 N MAIN ST, SOQUEL, CA 95073-2204
(831) 462-8750
(831) 475-5713
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G414340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G414340
—
CA
01
—
00G414341
MEDICARE INDIVIDUAL PIN
CA
01
—
1396885034
INDIVIDUAL NPI
CA
01
—
1861697328
GROUP NPI
CA
Enumeration date
06/15/2007
Last updated
11/27/2007
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