Provider Demographics
NPI:1083924260
Name:TRZCINSKI, TAMARA LYNN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNN
Last Name:TRZCINSKI
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:425 S FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2632
Mailing Address - Country:US
Mailing Address - Phone:626-449-8873
Mailing Address - Fax:
Practice Address - Street 1:2301 E FOOTHILL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4000
Practice Address - Country:US
Practice Address - Phone:626-852-3376
Practice Address - Fax:626-852-3375
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21283363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical