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General NPI Number Information
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NPI Number | 1982032520
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Entity Type | Organization
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Legal Business Name | TINCOPA MEDICAL CLINIC
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Dates
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Enumeration Date | 10/17/2013
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 6301 GREENLEAF AVE
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City | WHITTIER
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State | CA
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Zip | 90601-3536
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Country | US
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Telephone | 562-693-9880
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Fax |
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Provider Business Mailing Address
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Address Line | 6301 GREENLEAF AVE
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City | WHITTIER
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State | CA
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Zip | 90601-3536
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Country | US
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Telephone | 562-693-9880
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. TERESA ARELENE TINCOPA
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Credential | F.N.P
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Telephone | 562-693-9880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A25202
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License Number State | CA
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