MEDICARE: TAMER REZK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	A178729	CA

General Provider Information

NPI Number	:	1457810285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMER REZK MD

Provider Business Mailing Address
First Line	:	27385 HYATT CT
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-3700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12291 WASHINGTON BLVD STE 301
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90606-3815
Country	:	US
Telephone Number	:	562-698-0811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	10/14/2022

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