TAM TIET (NPI# 1285994244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285994244 |
| Entity Type | Individual |
| Full Name | TAM TIET |
| Credential | MD |
| Practice Address |
1383 N Mcdowell Blvd Ste 150 Petaluma CA 94954 |
| Mailing Address |
2350 W El Camino Real Fl 2 Mountain View CA 94040-6203 |
| Practice Telephone | 7073082840 |
| Practice Fax Number | 7075735376 |
| Mailing Telephone | 7073082840 |
| Mailing Fax Number | 7075735376 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2019-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A132568 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FEDERAL DEA LICENSE | FT4898005 | 01 |
| CA | STATE LICENSE | A132568 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 Raley Blvd, Suite 140, Chico, CA 959288351 | 5303425776 | 5308980178 |
| 3883 Airway Dr Ste 120, Santa Rosa, CA 954031678 | 7075214495 | 7075735421 |
| Street Address |
1383 N MCDOWELL BLVD STE 150 |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669719043 | Roger Evan Minkow | Family Medicine | 735 H St, Petaluma, CA 94952-4936 | 2013-01-06 |
| 1902976236 | El Rose Medical Group | Family Medicine | 24 West El Rose Ave, Petaluma, CA 94952 | 2006-11-08 |
| 1750472213 | Brian Bouch | Family Medicine | 616 Petaluma Blvd N, Suite C, Petaluma, CA 94952-2847 | 2006-09-27 |
| 1023043494 | Lana Ngoc Nguyen | Family Medicine | 3835 Cypress Dr, Suite 102, Petaluma, CA 94954-6965 | 2006-07-12 |
| 1083606776 | Kelly Pfeifer | Family Medicine | 1301 Southpoint Blvd, Petaluma, CA 94954-6858 | 2005-08-18 |
| 1013919190 | Daniel G White | Family Medicine | 3900 Lakeville Hwy, Petaluma, CA 94954-5698 | 2005-08-10 |
| 1366445785 | Michelle Davey | Family Medicine | 1179 N Mcdowell Blvd, Petaluma, CA 94954 | 2005-05-31 |
| 1588220636 | Northern California Medical Assoc | Family Medicine | 1116 B St, Petaluma, CA 94952-4054 | 2019-05-14 |
| 1427508241 | Ulysses Gomez | Family Medicine | 1179 N Mcdowell Blvd, Petaluma, CA 94954 | 2016-10-05 |
| 1801281027 | Scott Holmes | Family Medicine | 1179 N Mcdowell Blvd, Petaluma, CA 94954 | 2015-04-03 |
| Find all providers in PETALUMA | ||||
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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.