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NPI Code Detail

MEDICARE: MAISHA TATE

MEDICARE: MAISHA TATE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician

General Provider Information

NPI Number : 1104639947
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAISHA TATE
Provider Business Mailing Address
First Line : 5407 HILLEN DR
Second Line :
City : OAKLAND
State : CA
Zip : 94619-3253
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 401 GRAND AVE STE 350
Second Line :
City : OAKLAND
State : CA
Zip : 94610-5056
Country : US
Telephone Number : 415-725-3882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2025
Last Update Date : 07/02/2025

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Directions to “ MAISHA TATE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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