MEDICARE: TAMIMI MEDICAL GROUP

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1497985352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMIMI MEDICAL GROUP

Provider Business Mailing Address
First Line	:	667 PALM AVE
Second Line	:	SUITE A
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1243
Country	:	US
Telephone Number	:	619-575-8887
Fax Number	:	619-575-1374

Provider Business Practice Location Address
First Line	:	667 PALM AVE
Second Line	:	SUITE A
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1243
Country	:	US
Telephone Number	:	619-575-8887
Fax Number	:	619-575-1374

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ZIAD TAMIMI
Credential	:	M.D.
Telephone Number	:	619-575-8887

Provider Enumeration Date	:	07/24/2009
Last Update Date	:	07/01/2014

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