Mark Tavares

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Practice address

2230 9TH St
Sacramento, CA 95818-1310

Phone

(916) 448-7391

Fax

(916) 441-1600

NPI assigned

Nov 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1255512232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 9TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958181310",
            "telephone_number": "916-448-7391",
            "fax_number": "916-441-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 9TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958181310",
            "telephone_number": "916-448-7391",
            "fax_number": "916-441-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARES",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy John Tautz, M.D.
• Elham Tavakkol
• Tavallaei DMD Corp
• Tavallaei, D.M.D., Corporation
• Tavallaei, D.M.D., Corporation
• Daribel Taveras, MD
• Jennifer Renee Tavernetti, M.D.
• Tess Emily Tavill, M.S., CFY-SLP
• Clinton Taxdahl
• Theam Leng Tay, MD

• Case Management Agency in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.

Verify at the official NPI Registry.