Provider Demographics
NPI:1457565889
Name:TAMKOC, CAN MUSTAFA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAN
Middle Name:MUSTAFA
Last Name:TAMKOC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:MUSTAFA
Other - Last Name:TAMKOC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:37 SHAMAN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-8810
Mailing Address - Country:US
Mailing Address - Phone:702-540-3495
Mailing Address - Fax:
Practice Address - Street 1:22032 EL PASEO STE 130
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3947
Practice Address - Country:US
Practice Address - Phone:909-729-5079
Practice Address - Fax:909-729-5081
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN 8171207P00000X
CAA100094207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine