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General NPI Number Information
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NPI Number | 1073475216
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Entity Type | Individual
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Provider Name | SUSAN ANGIE TAMALE NP
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Gender | Female
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 4929 VAN NUYS BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1702
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Country | US
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Telephone | 818-907-2825
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Fax |
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Provider Business Mailing Address
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Address Line | 20752 W BUR OAK CIR
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City | PORTER RANCH
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State | CA
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Zip | 91326-4947
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 95034745
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95034745
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 95034745
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License Number State | CA
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