Provider Demographics
NPI:1386842631
Name:TUZNIK, NATASCHA MAREN (DO)
Entity Type:Individual
Prefix:
First Name:NATASCHA
Middle Name:MAREN
Last Name:TUZNIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NATASCHA
Other - Middle Name:MAREN STELLA
Other - Last Name:TUZNIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4150 V ST STE G500
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1460
Mailing Address - Country:US
Mailing Address - Phone:916-734-8516
Mailing Address - Fax:
Practice Address - Street 1:3000 Q ST FL 3
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816
Practice Address - Country:US
Practice Address - Phone:916-453-4966
Practice Address - Fax:916-739-1269
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003297A207R00000X
TXQ1677207R00000X, 208M00000X
CA20A16485208M00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX346974401Medicaid
TX346974401Medicaid