EBEN CLATTENBURG (NPI# 1184994857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184994857 |
| Entity Type | Individual |
| Full Name | EBEN CLATTENBURG |
| Practice Address |
167 Main St Tuba City AZ 86045 |
| Mailing Address |
1411 E 31st St Oakland CA 94602-1018 |
| Practice Telephone | 9282832662 |
| Mailing Telephone | 5104374564 |
| Mailing Fax Number | 5104378322 |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2018-10-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | A140008 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1411 E 31st St, Oakland, CA 946021018 | 5104374564 | 5104378322 |
| Street Address |
167 MAIN ST |
| City | TUBA CITY |
| State | AZ |
| Zip Code | 86045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699387183 | Michelle R Vickers | Radiology | 167 Main St, Tuba City, AZ 86045 | 2020-08-18 |
| 1205458080 | Casey Moore | Pharmacist | 167 Main St, Tuba City, AZ 86045-0600 | 2020-05-14 |
| 1144864794 | Christine Long | Pharmacist | 167 Main St, Tuba City, AZ 86045 | 2019-11-06 |
| 1275195315 | Yolanda Li | Optometrist | 167 Main St, Tuba City, AZ 86045 | 2019-06-28 |
| 1700375664 | Adnew M Workneh | Pharmacist | 167 Main St, Tuba City, AZ 86045 | 2018-05-07 |
| 1265940183 | Sara Bekele | Pharmacist | 167 Main St, Tuba City, AZ 86045 | 2018-01-12 |
| 1861948291 | Kimberly June Frantz | Pharmacist | 167 Main St, Tuba City, AZ 86045 | 2016-08-26 |
| 1821428517 | Jenessa Payano Stark | Midwife | 167 Main St, Tuba City, AZ 86045 | 2013-11-18 |
| 1699934281 | Jolene Tom | Registered Nurse | 167 Main St, Tuba City, AZ 86045-0600 | 2008-06-09 |
| 1558549782 | Grant Raymond Bender | Pharmacist | 167 Main St, Tuba City, AZ 86045 | 2008-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
| 1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| 1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
| 1023452984 | Amanda Bancroft Burrage | Pediatrics | 167 Main St., Tuba City, AZ 86045 | 2013-04-23 |
| Find all providers in zip 86045 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851774111 | Tessa Stamile | Emergency Medicine | 167 North Main Street, Tuba City, AZ 86045 | 2015-07-06 |
| 1891094181 | Kenneth R Bernard | Emergency Medicine | 167 North Main Street, Tuba City, AZ 86045-0600 | 2011-03-25 |
| 1962720888 | Thomas James Grosheider | Emergency Medicine | 167 N. Main St., Tuba City, AZ 86045 | 2010-05-17 |
| 1730343443 | Edward Chu | Emergency Medicine | 167 N Main St, Tuba City, AZ 86045 | 2008-07-11 |
| 1013138130 | Summer D Stears-ellis | Emergency Medicine | 167 North Main Street, Tuba City, AZ 86045-0600 | 2007-05-02 |
| 1023179355 | Jeffrey Todd Mason | Emergency Medicine | 167 North Main Street, Tuba City, AZ 86045 | 2006-12-12 |
| 1619998200 | Pearish J Smith | Emergency Medicine | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-07-21 |
| 1063455160 | Thomas D Beck | Emergency Medicine | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-06-14 |
| 1932142189 | David J Lang | Emergency Medicine | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-06-14 |
| 1043253180 | Margaret E Blaisdell | Emergency Medicine | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-06-14 |
| Find all providers in TUBA CITY | ||||
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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.