Individual
MR. GENE T OMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
16120 WEST DODGE ROAD, OMAHA, NE 38118
(402) 354-0707
(402) 354-0711
Mailing address
P.O. BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1205
NE
363AS0400X
Surgical Physician Assistant
1205
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38642
BCBS
NE
01
—
P00353556
RAILROAD MEDICARE
—
Enumeration date
06/07/2006
Last updated
09/22/2009
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