Healthcare Provider Details

I. General information

NPI: 1346539707
Provider Name (Legal Business Name): TANYA NICOLE RINDERKNECHT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 STOCKTON BLVD. - DEPARTMENT OF SURGERY NAOB SUITE 5023
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2335 STOCKTON BLVD. - DEPARTMENT OF SURGERY NAOB SUITE 5023
SACRAMENTO CA
95817-2201
US

V. Phone/Fax

Practice location:
  • Phone: 650-208-9471
  • Fax:
Mailing address:
  • Phone: 650-208-9471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA122099
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA122099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: