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General NPI Number Information
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NPI Number | 1902048382
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Entity Type | Individual
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Provider Name | TANYA JOE JUDGE MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2009
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1199 BUSH ST STE 490
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-5987
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Country | US
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Telephone | 415-409-9760
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Fax | 415-358-1879
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Provider Business Mailing Address
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Address Line | 1199 BUSH ST STE 490
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-5987
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Country | US
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Telephone | 415-409-9760
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Fax | 415-358-1879
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | A117707
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License Number State | CA
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