MEDICARE: TANCREDI F. D'AMORE, M.D FACS. A MEDICAL CORPORATION

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	2086S0105X	Surgery of the Hand (Surgery) Physician
2	2086S0122X	Plastic and Reconstructive Surgery Physician

General Provider Information

NPI Number	:	1952327587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TANCREDI F. D'AMORE, M.D FACS. A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	21 TAMAL VISTA BLVD STE 103
Second Line	:
City	:	CORTE MADERA
State	:	CA
Zip	:	94925-1130
Country	:	US
Telephone Number	:	415-927-7660
Fax Number	:	415-927-7663

Provider Business Practice Location Address
First Line	:	21 TAMAL VISTA BLVD STE 103
Second Line	:
City	:	CORTE MADERA
State	:	CA
Zip	:	94925-1130
Country	:	US
Telephone Number	:	415-927-7660
Fax Number	:	415-927-7663

Authorized Official
Title or Position	:	BILLING SPECIALIST
Name	:	COLLEEN E MORF
Credential	:
Telephone Number	:	415-927-7660

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	08/05/2010

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