Tanner, J Lane

Tanner, J Lane is an individual health care provider with primary practice located at 747 52Nd St Chrco Child Development Center, Oakland CA 94609-1809. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. Tanner, J Lane can be contacted via phone (510) 428-3351.

Contact Information

Primary practice address
747 52Nd St Chrco Child Development Center Oakland CA 94609-1809
Phone: (510) 428-3351
Fax: (510) 601-3912
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X G28611 California

Profile Details

NPI number 1235206350
LBN Legal business name Tanner, J Lane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jul 8th, 2007 - about 19 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 1235206350 NPPES
California MEDICAID GR0095850

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