DR. TAMMAM BEYDOUN (NPI# 1033349014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033349014 |
| Entity Type | Individual |
| Full Name | DR. TAMMAM BEYDOUN |
| Credential | D.O. |
| Practice Address |
2101 N Waterman Ave San Bernardino CA 92404-4836 |
| Mailing Address |
645 E Missouri Ave Ste 300 Phoenix AZ 85012-1351 |
| Practice Telephone | 9098838711 |
| Mailing Telephone | 4805002474 |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2019-01-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
006430 | AZ | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
5101019006 | MI | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
012302 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
2101 N WATERMAN AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-4836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992797153 | Young A Suk | Anesthesiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2005-08-15 |
| 1467077016 | Melissa Magdangal | Occupational Therapist | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-06-10 |
| 1902433303 | Ariel Chen | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-03-25 |
| 1417581059 | Western Acute Care Surgeons Inc | Surgery | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2020-02-22 |
| 1538704234 | Michelle Dela Cruz Villanueva | Occupational Therapist | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-11-17 |
| 1750943668 | Benjamin Arthur Rinard | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-07-01 |
| 1679132955 | Louis Gallo | Physician Assistant | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-06-10 |
| 1154984706 | Antonio Moreno | Anesthesiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-18 |
| 1003378944 | Miranda G Ideal | Nurse Anesthetist, Certified Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-04-01 |
| 1225599780 | Kylie Brenna Leeper | Dietitian, Registered | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2019-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306136 | Renaissance Radiology Medical Group, Inc. | Radiology | 1805 Medical Center Dr, San Bernardino, CA 92411-1217 | 2005-06-15 |
| 1912928565 | Renaissance Radiology Medical Group, Inc | Radiology | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2006-07-21 |
| 1225012644 | Renaissance Radiology Med Grp Inc | Radiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739949 | Ava Vascular | Radiology | 1281 W. C. Street, Suite 200, Colton, CA 92324 | 2020-08-06 |
| 1306467204 | Saleh Radiology of Inland Empire | Radiology | 15276 Ledgestone St, Fontana, CA 92336-4048 | 2020-05-01 |
| 1366084535 | Luo Xu | Radiology | 757 Westwood Plz # 2146, Los Angeles, CA 90095-8358 | 2019-10-09 |
| 1346717824 | Cvs Medical Group, Inc | Radiology | 201 W Garvey Ave Ste 102-502, Monterey Park, CA 91754-7418 | 2018-11-01 |
| 1407353675 | Art Vascular & Interventional Associates Inc | Radiology | 324 S Beverly Dr Ste 345, Beverly Hills, CA 90212-4801 | 2018-04-12 |
| 1568971869 | Broad Reach Specialty Surgery Inc | Radiology | 8117 West Manchester Ave, Ste 368, Playa Del Rey, CA 90293 | 2017-09-29 |
| 1407393754 | Valley Vascular Partners Inc | Radiology | 19231 Victory Blvd Ste 155, Reseda, CA 91335-6329 | 2017-01-25 |
| 1124497342 | Neurointerventional Surgery Consultants, PC | Radiology | 534 S Brea Blvd, Brea, CA 92821-5304 | 2015-09-17 |
| 1578946026 | Clarity Radiology, LLC | Radiology | 39 Via Navarro, Greenbrae, CA 94904-1215 | 2015-07-01 |
| 1669863981 | Pedes Vascular San Fernando Valley | Radiology | 16260 Ventura Boulevard, Suite 210, Encino, CA 91436-2203 | 2015-02-09 |
| Find all providers with the same taxonomy | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.