MEDICARE: ANDREA TAMAS LVN

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	164X00000X	Licensed Vocational Nurse	VN 185230	CA

General Provider Information

NPI Number	:	1710270202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA TAMAS LVN

Provider Business Mailing Address
First Line	:	927 N KINGS RD
Second Line	:	#304
City	:	LOS ANGELES
State	:	CA
Zip	:	90069-4350
Country	:	US
Telephone Number	:	323-650-6024
Fax Number	:

Provider Business Practice Location Address
First Line	:	927 N KINGS RD
Second Line	:	#304
City	:	LOS ANGELES
State	:	CA
Zip	:	90069-4350
Country	:	US
Telephone Number	:	323-650-6024
Fax Number	:

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

Provider Enumeration Date	:	05/17/2011
Last Update Date	:	05/17/2011

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