Michael Tannenbaum, PA

NPI #1457553885 in Modesto, California

Provider Information

NPI Number: 1457553885
Entity Type: Individual
Name: Michael Tannenbaum, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jun 5, 2007
Last Updated: Jun 12, 2009

Practice Location

Address: 1808 SCENIC DR
Address 2: APT 107
City: Modesto
State: California
ZIP Code: 95355
Phone: (510) 409-8966

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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