Provider Demographics
NPI:1760744395
Name:BEG, TASNIM MIRZA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:TASNIM
Middle Name:MIRZA
Last Name:BEG
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5568 GIBRALTAR DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8544
Mailing Address - Country:US
Mailing Address - Phone:925-534-6500
Mailing Address - Fax:925-534-6701
Practice Address - Street 1:5568 GIBRALTAR DR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8544
Practice Address - Country:US
Practice Address - Phone:925-534-6500
Practice Address - Fax:925-534-6701
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD457498207Q00000X
CAA156688207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD457498OtherMEDICAL LICENSE