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General NPI Number Information
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NPI Number | 1679553804
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Entity Type | Individual
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Provider Name | TAMMI KAY MCCOMAK FNP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 530 W EATON AVE SUITE K
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City | TRACY
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State | CA
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Zip | 95376-3400
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Country | US
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Telephone | 209-835-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 561 HANSEN CT
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City | PATTERSON
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State | CA
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Zip | 95363-9315
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Country | US
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Telephone | 209-892-5369
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 15459
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License Number State | CA
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