MICHAEL TANNENBAUM (NPI# 1457553885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457553885 |
| Entity Type | Individual |
| Full Name | MICHAEL TANNENBAUM |
| Credential | PA |
| Practice Address |
1808 Scenic Dr Apt 107 Modesto CA 95355 |
| Mailing Address |
1808 Scenic Dr Apt 107 Modesto CA 95355-4947 |
| Practice Telephone | 5104098966 |
| Mailing Telephone | 5104098966 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2009-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA01230 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992845598 | Michael G Tannenbaum | Chiropractor | 4059 Stone School Rd, Ann Arbor, MI 48108-9723 | 2007-02-06 |
| Street Address |
1808 SCENIC DR APT 107 |
| City | MODESTO |
| State | CA |
| Zip Code | 95355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
| Find all providers in zip 95355 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609330109 | Daniel Antonio Villagran-gonzalez | Physician Assistant | 1401 Spanos Ct Ste 130, Modesto, CA 95355-2815 | 2019-01-29 |
| 1255823191 | Laura Lee Ruby Goen | Physician Assistant | 3105 Mchenry Ave Ste 10, Modesto, CA 95350-1439 | 2018-06-06 |
| 1679086755 | Danielle B Deen | Physician Assistant | 1541 Florida Ave Ste 100, Modesto, CA 95350-4438 | 2017-11-10 |
| 1598292724 | Todd Brooks | Physician Assistant | 1800 Coffee Rd Ste 30, Modesto, CA 95355-2700 | 2017-05-18 |
| 1205240660 | David Zarate Rojas | Physician Assistant | 405 Mid Pines Way, Modesto, CA 95354-3378 | 2014-06-13 |
| 1194151704 | Harinder Jhatu | Physician Assistant | 2218 W Whitmore Ave, Modesto, CA 95358-9497 | 2013-09-16 |
| 1902191489 | Heather Marie Clayton-young | Physician Assistant | 3509 Coffee Rd Ste D3, Modesto, CA 95355-1357 | 2011-06-13 |
| 1013139054 | Bounchanh Trysavath | Physician Assistant | 300 I St, Modesto, CA 95351 | 2007-05-02 |
| 1942378583 | Karen Fields | Physician Assistant | Valley Wound Healing Center, 4335a Nstarway, Modesto, CA 95356 | 2006-12-01 |
| 1760594154 | Stephen Andrew Fall | Physician Assistant | 1335 Coffee Rd Ste 100, Modesto, CA 95355-3192 | 2006-08-31 |
| Find all providers in MODESTO | ||||
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| 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.