MEDICARE: FATMA ELA TAHMAZ GUNDOGDU 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	208000000X	Pediatrics Physician	C203036	CA

General Provider Information

NPI Number	:	1942196860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATMA ELA TAHMAZ GUNDOGDU MD

Provider Business Mailing Address
First Line	:	2139 WILMINGTON DR
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-6238
Country	:	US
Telephone Number	:	925-849-2111
Fax Number	:

Provider Business Practice Location Address
First Line	:	2139 WILMINGTON DR
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-6238
Country	:	US
Telephone Number	:	925-849-2111
Fax Number	:

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

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	06/16/2025

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