MEDICARE: DR. BEATRIZ TAMAYO MD

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
1	207R00000X	Internal Medicine Physician	A74662	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144396383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEATRIZ TAMAYO MD

Provider Business Mailing Address
First Line	:	PO BOX 3909
Second Line	:
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-9541
Country	:	US
Telephone Number	:	213-250-0050
Fax Number	:	213-250-0150

Provider Business Practice Location Address
First Line	:	1127 WILSHIRE BLVD STE 202
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-3903
Country	:	US
Telephone Number	:	213-250-0050
Fax Number	:	213-250-0150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	03/25/2014

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