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General NPI Number Information
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NPI Number | 1306633276
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Entity Type | Organization
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Legal Business Name | TAMPA MEDICAL, INC.
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 6047 TAMPA AVE STE 102
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City | TARZANA
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State | CA
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Zip | 91356-1167
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Country | US
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Telephone | 818-400-9227
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Fax | 818-337-2180
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Provider Business Mailing Address
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Address Line | 6047 TAMPA AVE STE 102
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City | TARZANA
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State | CA
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Zip | 91356-1167
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Country | US
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Telephone | 818-400-9227
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Fax | 818-337-2180
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Authorized Official
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Title or Position | OFFICE DIRECTOR
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Name | SAM MASHHOUD
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Credential |
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Telephone | 818-400-9227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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