Tanner, Garth B
Tanner, Garth B is an sole proprietor health care provider with primary practice located at 1429 College Ave Ste K, Modesto CA 95350-4057. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tanner, Garth B can be contacted via phone (209) 521-7800.Contact Information
Primary practice address
1429 College Ave Ste K
Modesto CA 95350-4057
Phone: (209) 521-7800
Fax: (209) 521-5733
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A64407 | California |
Profile Details
| NPI number | 1184612624 |
|---|---|
| LBN Legal business name | Tanner, Garth B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Jul 12th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184612624 | NPPES |
| California | MEDICAID | 00A644070 |
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