Healthcare Provider Details

I. General information

NPI: 1487639795
Provider Name (Legal Business Name): JOSEPH M TUSCANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 08/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 X ST STE 3016
SACRAMENTO CA
95817-2229
US

IV. Provider business mailing address

4501 X ST SUITE 3016
SACRAMENTO CA
95817-2229
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5981
  • Fax: 916-734-0631
Mailing address:
  • Phone: 916-734-3771
  • Fax: 916-734-7946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG69025
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG069025
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG069025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: