Individual
THOMAS TALAVERA EMBRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PATIENT CARE TECH
Contact information
Practice address
27433 CAPRI AVE, HAYWARD, CA 94545-4001
(510) 487-2891
(510) 487-2891
Mailing address
27433 CAPRI AVE, HAYWARD, CA 94545-4001
(510) 487-2891
(510) 487-2891
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C3382190
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MTN00905F
MEDI-CAL PROVIDER'S NUMBE
CA
Enumeration date
05/15/2007
Last updated
07/08/2007
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