Tantam Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A71362 Issued in CA

Legal business name

TANTAM MEDICAL GROUP, INC.

Practice address

1610 W Edinger Ave Ste B
Santa Ana, CA 92704-4339

Phone

(714) 641-1610

Fax

(714) 641-1146

NPI assigned

Sep 8, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Pumipak Tantamjarik, MD, FAAFP

Title

Physician

Phone

(714) 641-1610

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Srivimol Tantamjarik, M.D., F.A.A.P.

  • Pediatrics Physician
  • Santa Ana, CA
  • NPI 1508828856
  NPD (past)
• William To, PA

  • Physician Assistant
  • Garden Grove, CA
  • NPI 1336425644
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1154315828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 W EDINGER AVE STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044339",
            "telephone_number": "714-641-1610",
            "fax_number": "714-641-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 W EDINGER AVE STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044339",
            "telephone_number": "714-641-1610",
            "fax_number": "714-641-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANTAM MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "TANTAMJARIK",
        "authorized_official_first_name": "PUMIPAK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "714-641-1610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, FAAFP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A71362",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A31595",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A31442",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0027840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Tang, RN, FNP-BC
• Nhiep Tang, MD
• Editha Tanig-Sanjongco, FNP-BC
• Kahelelani Yuk Lin Tanouye
• Camille Tanquilut, M.D.
• Pumipak Tantamjarik, MD, FAAFP
• Srivimol Tantamjarik, M.D., F.A.A.P.
• Lauren Tantillo, CADC-III, B.S.
• Tanya V Martinez Chiropractic Inc
• Ted Leslie Tanzer, M.D.

• Family Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.