Healthcare Provider Details

I. General information

NPI: 1992105175
Provider Name (Legal Business Name): FRANCES M. TINKER, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17300 MARILLA ST
NORTHRIDGE CA
91325-1824
US

IV. Provider business mailing address

17300 MARILLA ST
NORTHRIDGE CA
91325-1824
US

V. Phone/Fax

Practice location:
  • Phone: 818-590-1003
  • Fax:
Mailing address:
  • Phone: 818-590-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG040572
License Number StateCA

VIII. Authorized Official

Name: ROBIN WAYNE LARSON
Title or Position: PARTNER
Credential: MD
Phone: 818-590-1003