Provider Demographics
NPI:1629147533
Name:TANDINCO, ARTOTELES L (MD)
Entity Type:Individual
Prefix:
First Name:ARTOTELES
Middle Name:L
Last Name:TANDINCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1564A FITZGERALD DR # 158
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2229
Mailing Address - Country:US
Mailing Address - Phone:707-372-3801
Mailing Address - Fax:949-757-2534
Practice Address - Street 1:3393 PEBBLE BEACH CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-8308
Practice Address - Country:US
Practice Address - Phone:707-372-3801
Practice Address - Fax:949-757-2534
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA448942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A448941Medicare ID - Type Unspecified