DR. TANCREDI F DAMORE (NPI# 1619958907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619958907 |
| Entity Type | Individual |
| Full Name | DR. TANCREDI F DAMORE |
| Credential | MD |
| Practice Address |
21 Tamal Vista Blvd Suite 103 Corte Madera CA 94925-1130 |
| Practice Telephone | 4159277660 |
| Practice Fax Number | 4159277663 |
| Mailing Telephone | 4159277660 |
| Mailing Fax Number | 4159277663 |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2012-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
A51587 | CA | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
A51587 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PPIN | 00A515871 | 01 | |
| CA | 00A515871 | 05 |
| Street Address |
21 TAMAL VISTA BLVD SUITE 103 |
| City | CORTE MADERA |
| State | CA |
| Zip Code | 94925-1130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134117435 | Arnold Knepfer | Psychiatry & Neurology | 21 Tamal Vista Blvd, 212, Corte Madera, CA 94925-1130 | 2005-10-11 |
| 1083164701 | Paul Anthony Marra | Marriage & Family Therapist | 21 Tamal Vista Blvd, Suite 200, Corte Madera, CA 94925-1130 | 2016-10-05 |
| 1124572755 | Pamela Margaret Ashkenazy | Counselor | 21 Tamal Vista Blvd, Suite 116, Corte Madera, CA 94925-1130 | 2016-08-11 |
| 1548612757 | Emily Smith Acupuncture, Inc | Clinic/Center | 21 Tamal Vista Blvd, Suite 175, Corte Madera, CA 94925-1130 | 2016-07-12 |
| 1760849723 | Deidrae Moffett | Counselor | 21 Tamal Vista Blvd, 194, Corte Madera, CA 94925-1130 | 2016-01-21 |
| 1609252931 | Stephen H. Sulmeyer | Psychologist | 21 Tamal Vista Blvd, Suite 215, Corte Madera, CA 94925-1130 | 2015-08-10 |
| 1013313337 | Farahkhan,md,inc | Psychiatry & Neurology | 21 Tamal Vista Blvd, 224, Corte Madera, CA 94925-1130 | 2014-11-13 |
| 1578975074 | Grace Ellen Roegiers | Speech-Language Pathologist | 21 Tamal Vista Blvd, 187, Corte Madera, CA 94925-1130 | 2014-06-02 |
| 1588082911 | Tisha Mallon | Acupuncturist | 21 Tamal Vista Blvd, Corte Madera, CA 94925-1130 | 2014-04-02 |
| 1720406457 | Steps To Freedom | Community/Behavioral Health | 21 Tamal Vista Blvd, Suite 226, Corte Madera, CA 94925-1130 | 2014-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386139061 | California Center for Ms and Neurology Inc | Psychiatry & Neurology | 21 Tamal Vista Blvd Ste 175, Corte Madera, CA 94925 | 2018-06-26 |
| 1982130514 | Summer Nipomnick | Psychologist | 200 Tamal Plaza, Suite 235, Corte Madera, CA 94925 | 2017-05-02 |
| 1376784561 | Marcie Morton | Chiropractor | 2 Fifer Ave Ste 130, Corte Madera, CA 94925 | 2009-03-17 |
| 1154598365 | Kristine Kay Twite Lehnen | Registered Nurse | 42 Creekside Ct, Corte Madera, CA 94925 | 2008-05-15 |
| 1811163884 | Susan Mary Nickerson | Nurse Anesthetist, Certified Registered | 239 Koch Rd, Corte Madera, CA 94925 | 2008-04-30 |
| 1225150485 | Noreen P Dunnigan | Marriage & Family Therapist | 200 Tamal Plaza, Ste 135, Corte Madera, CA 94925 | 2007-04-06 |
| 1356477889 | Rochelle L Teising | Marriage & Family Therapist | 100 Tamal Vista, #160, Corte Madera, CA 94925 | 2007-02-26 |
| 1518019181 | Lynne Harris | Psychologist | 100 Tamal Plaza, Suite 108, Corte Madera, CA 94925 | 2007-01-17 |
| 1801975032 | Julie B Young | Dentist | 81 Casa Buena, Suite 6, Corte Madera, CA 94925 | 2006-11-06 |
| 1033294020 | Ann Margaret O'hare | Internal Medicine | 155 Golden Hind Passage, Corte Madera, CA 94925 | 2006-10-26 |
| Find all providers in zip 94925 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382523 | Beverly Hills Outpatient Surgery Center Inc | Surgery | 50 N La Cienega Blvd Ste 203, Beverly Hills, CA 90211-2246 | 2020-09-24 |
| 1558907857 | California Surgical and Anesthesia Services, Inc | Surgery | 3500 S Bristol St Ste 203, Santa Ana, CA 92704-7306 | 2019-11-21 |
| 1710533864 | Elite Transformations, A Professional Medical Corporation | Surgery | 1795 El Camino Real Ste 200, Palo Alto, CA 94306-1165 | 2019-08-14 |
| 1326503632 | Andre P. Marshall, Md Inc | Surgery | 32456 Crown Valley Pkwy Apt 105, Dana Point, CA 92629-3312 | 2019-01-31 |
| 1598245474 | Jenny Marie Hullinger | Surgery | 711 4th Ave Ste 200, San Diego, CA 92101-6863 | 2018-08-20 |
| 1497249817 | Alexander Villicana Md LLC | Surgery | 624 W Duarte Rd Ste 201, Arcadia, CA 91007-9261 | 2018-06-19 |
| 1316431273 | Justin E. West, Md Inc. | Surgery | 230 S Main St Ste 210, Orange, CA 92868-3851 | 2018-06-14 |
| 1811430234 | Marc Hamilton Hedrick | Surgery | 3020 Callan Rd, San Diego, CA 92121-1109 | 2016-12-02 |
| 1285082859 | Daniel Suissa | Surgery | 9201 W Sunset Blvd Ste 708, West Hollywood, CA 90069-3708 | 2016-05-24 |
| 1780030478 | Eric Yu Kit Li | Surgery | 10430 S De Anza Blvd Ste 170, Cupertino, CA 95014-3000 | 2016-05-11 |
| Find all providers with the same taxonomy | ||||
| City | CORTE MADERA |
| Zip Code | 94925 |
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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.