MEDICARE: GARDNER D TARLOW MD INC

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	207Q00000X	Family Medicine Physician	A71363	CA

General Provider Information

NPI Number	:	1518259084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDNER D TARLOW MD INC

Provider Business Mailing Address
First Line	:	1781 W ROMNEYA DR STE C
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-1818
Country	:	US
Telephone Number	:	714-772-2210
Fax Number	:	714-774-2826

Provider Business Practice Location Address
First Line	:	1781 W ROMNEYA DR STE C
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-1818
Country	:	US
Telephone Number	:	714-772-2210
Fax Number	:	714-774-2826

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GARDNER TARLOW
Credential	:	MD
Telephone Number	:	714-772-2210

Provider Enumeration Date	:	05/03/2011
Last Update Date	:	01/19/2026

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