Healthcare Provider Details
I. General information
NPI: 1295128460
Provider Name (Legal Business Name): TNDM HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2015
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
971 N MAIN ST SUITE 5
SALINAS CA
93906-3957
US
IV. Provider business mailing address
971 N MAIN ST SUITE 5
SALINAS CA
93906-3957
US
V. Phone/Fax
- Phone: 831-272-6458
- Fax: 831-272-6529
- Phone: 831-272-6458
- Fax: 831-272-6529
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
TAM
NGUYEN
Title or Position: CEO
Credential: M.D.
Phone: 408-258-5083