Provider Demographics
NPI:1720136138
Name:TANSON, ELVIS AKPENE (DO)
Entity Type:Individual
Prefix:DR
First Name:ELVIS
Middle Name:AKPENE
Last Name:TANSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2820 LONNIE BECK WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4188
Mailing Address - Country:US
Mailing Address - Phone:209-406-6474
Mailing Address - Fax:209-476-1651
Practice Address - Street 1:4873 WEST LN STE A
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-4548
Practice Address - Country:US
Practice Address - Phone:298-472-1515
Practice Address - Fax:209-472-1651
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2014-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7605207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine