Martin, Grace Tandoc

Martin, Grace Tandoc is an individual health care provider with primary practice located at 1165 Montgomery Dr , Santa Rosa CA 95405-4801. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Martin, Grace Tandoc can be contacted via phone (707) 303-8321.

Contact Information

Primary practice address
1165 Montgomery Dr Santa Rosa CA 95405-4801
Phone: (707) 303-8321
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X A83664 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A83664 California

Profile Details

NPI number 1356454086
LBN Legal business name Martin, Grace Tandoc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated Sep 27th, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356454086 NPPES
California MEDICAID GR0061380

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