Individual
DR. WYNNIS L. TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8010 FROST ST, STE 602, SAN DIEGO, CA 92123-2778
(858) 966-6795
(858) 966-4040
Mailing address
3860 CALLE FORTUNADA, STE #210, SAN DIEGO, CA 92123-4802
(858) 309-6303
(858) 309-6301
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A99290
CA
207NP0225X
Pediatric Dermatology Physician
Primary
A99290
CA
Other
Enumeration date
05/17/2007
Last updated
09/19/2011
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