EITAN HOMA (NPI# 1326120718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326120718 |
| Entity Type | Individual |
| Full Name | EITAN HOMA |
| Credential | M.D. |
| Practice Address |
165 Lynch Creek Way Petaluma CA 94954-2343 |
| Mailing Address |
500 Alfred Nobel Dr Suite 245 Hercules CA 94547-1838 |
| Practice Telephone | 7077625531 |
| Practice Fax Number | 7077625976 |
| Mailing Telephone | 5107417299 |
| Mailing Fax Number | 5107417493 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2015-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE RAILROAD | 070012651 | 01 |
| CA | LICENSE NUMBER | A64754 | 01 |
| Street Address |
165 LYNCH CREEK WAY |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-2343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215934096 | Carla Anna Fisher | Dermatology | 165 Lynch Creek Way, Petaluma, CA 94954-2343 | 2005-07-07 |
| 1891821427 | Eitan Homa and Jennifer Krasnoff Md Inc | Dermatology | 165 Lynch Creek Way, Petaluma, CA 94954-2343 | 2007-02-26 |
| 1043373889 | Bertha Bin-san Lin | Dermatology | 165 Lynch Creek Way, Petaluma, CA 94954-2343 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780101568 | Asp Providers Group of California, PC | Specialist | 1350 Barlas Ln, Petaluma, CA 94952-1280 | 2017-08-23 |
| 1285096008 | Sean Hardcaslte | Specialist | 1120 Industrial Ave, Suite 13 & 14, Petaluma, CA 94952-6503 | 2016-03-22 |
| 1538559018 | Summit Pain Alliance Inc | Specialist | 157 Lynch Creek Way, Petaluma, CA 94954-2342 | 2015-02-04 |
| 1497921258 | Francesca Fasano | Specialist | 127 4th St, Petaluma, CA 94952-3005 | 2008-05-01 |
| 1649480039 | Amanda C. Wongsonegoro | Specialist | 35 Petaluma Blvd N, Petaluma, CA 94952-3001 | 2007-05-23 |
| 1053359984 | Roy S Musick | Specialist | 517 Lincoln Ln, Petaluma, CA 94954-3831 | 2006-06-03 |
| 1710980321 | Lance B Barlas | Specialist | 167 Lynch Creek Way, Petaluma, CA 94954-2343 | 2005-05-27 |
| 1134777006 | Elizabeth Pak | Specialist | 1670 Corporate Cir Ste 100, Petaluma, CA 94954-6947 | 2019-09-03 |
| 1841765666 | Alice Fitzwater | Specialist | 1670 Corporate Cir Ste 100, Petaluma, CA 94954 | 2018-10-08 |
| 1710338744 | Kayla Sibbaluca | Specialist | 201 Fair St, Petaluma, CA 94952-2516 | 2016-06-30 |
| Find all providers in PETALUMA | ||||
Please comment or provide details below to improve the information on EITAN HOMA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.