Provider Demographics
NPI:1003863341
Name:TUMAKAY, SUE ANN ESTRADA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SUE ANN
Middle Name:ESTRADA
Last Name:TUMAKAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 N. ROSE DR.
Mailing Address - Street 2:SUITE 122
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3919
Mailing Address - Country:US
Mailing Address - Phone:714-961-0808
Mailing Address - Fax:714-961-0115
Practice Address - Street 1:1275 N ROSE DR
Practice Address - Street 2:SUITE 122
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3941
Practice Address - Country:US
Practice Address - Phone:714-961-0808
Practice Address - Fax:714-961-0115
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 17273363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant