Active NPI
Imelda Maria C. Tandinco, M.D.
- Pediatrics Physician
- Fairfield, CA
National Provider Identifier
1093996092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A100134
- Practice address
- 2101 Courage Dr
Fairfield, CA 94533-6717 - Phone
- (707) 784-2012
- NPI assigned
- Nov 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A100134 | CA | Primary |
Addresses
Primary practice location
2101 Courage Dr
Fairfield, CA 94533-6717
Mailing address
3393 Pebble Beach CT
Fairfield, CA 94534-8308
Phone (707) 434-9044
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A100134 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195344000000",
"number": "1093996092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3393 PEBBLE BEACH CT",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945348308",
"telephone_number": "707-434-9044",
"fax_number": "707-434-9455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 COURAGE DR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945336717",
"telephone_number": "707-784-2012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANDINCO",
"first_name": "IMELDA MARIA",
"middle_name": "C.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-18",
"last_updated": "2007-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A100134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.