NPI Code Details Logo

NPI 1225335409

NPI 1225335409 : CHONDRA E TANNER OTR : ANAHEIM, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1225335409
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CHONDRA E TANNER OTR
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/23/2011
-----------------------------------------------------
    Last Update Date     |    02/23/2011
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    501 S BEACH BLVD 
-----------------------------------------------------
    City                 |    ANAHEIM
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92804-1810
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    714-816-0540
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    20691 VIA SONRISA 
-----------------------------------------------------
    City                 |    YORBA LINDA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92886-4618
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    714-742-1071
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    OT9331
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.