Provider Demographics
NPI:1982032520
Name:TINCOPA MEDICAL CLINIC
Entity Type:Organization
Organization Name:TINCOPA MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ARELENE
Authorized Official - Last Name:TINCOPA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:562-693-9880
Mailing Address - Street 1:6301 GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-3536
Mailing Address - Country:US
Mailing Address - Phone:562-693-9880
Mailing Address - Fax:
Practice Address - Street 1:6301 GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-3536
Practice Address - Country:US
Practice Address - Phone:562-693-9880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty