Cavanaugh, Tanner

Cavanaugh, Tanner is an sole proprietor health care provider with primary practice located at 3105 Mchenry Ave Ste 101 , Modesto CA 95350-1439. He recently has 2 registered licenses in different health care specialties including Emergency Medical Service Providers / Emergency Medical Technician, Basic, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Cavanaugh, Tanner can be contacted via phone (209) 575-2700.

Contact Information

Primary practice address
3105 Mchenry Ave Ste 101 Modesto CA 95350-1439
Phone: (209) 575-2700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Emergency Medical Technician, Basic 146N00000X 74381 Nevada
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 59206 California

Profile Details

NPI number 1811394976
LBN Legal business name Cavanaugh, Tanner
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 4th, 2014
Last updated May 17th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1811394976 NPPES
Nevada Other 74381 EMT LICENSCE

Popular Providers