Provider Demographics
NPI:1205888450
Name:TUOHEY-MOTE, ALAN DAVID (FNP)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:DAVID
Last Name:TUOHEY-MOTE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10333 EL CAMINO REAL RM 205
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-5808
Mailing Address - Country:US
Mailing Address - Phone:805-468-2188
Mailing Address - Fax:
Practice Address - Street 1:10333 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93423-7001
Practice Address - Country:US
Practice Address - Phone:805-468-2000
Practice Address - Fax:805-466-6011
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ01774ZMedicare ID - Type Unspecified
P10706Medicare UPIN