Provider Demographics
NPI:1326291402
Name:TAMADDONI, MICHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:TAMADDONI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 DIABLO RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-3481
Mailing Address - Country:US
Mailing Address - Phone:925-855-8350
Mailing Address - Fax:925-855-8351
Practice Address - Street 1:315 DIABLO RD
Practice Address - Street 2:SUITE 110
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3481
Practice Address - Country:US
Practice Address - Phone:925-855-8350
Practice Address - Fax:925-855-8351
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist