Jay Gerard Tassin, M.D.

Primary specialty

Therapeutic Radiology PhysicianTaxonomy code 2085R0203X

License

ABR BOARD CERT. 1993 Issued in CA

Practice address

675 Camino de Los Mares
Suite 400
San Clemente, CA 92673-2835

Phone

(949) 248-4547

NPI assigned

Jul 10, 2014

Last updated

Jul 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Dermatology Inc.

  dba Advanced Dermatology of San Clemente Inc

  • Dermatology Physician
  • Dana Point, CA
  • NPI 1336220540
  NPD (past)
• Newport Coast Radiation Oncology Medical Group, Inc

  • Radiation Oncology Physician
  • Newport Beach, CA
  • NPI 1518908847

  Therapeutic Radiology

  NPD (past)

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1659787596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W 17TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011008",
            "telephone_number": "512-786-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 CAMINO DE LOS MARES",
            "address_2": "SUITE 400",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732835",
            "telephone_number": "949-248-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSIN",
        "first_name": "JAY",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "CA",
            "license": "ABR BOARD CERT. 1993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA PHYSICIAN & SURGEON'S LICENSE",
            "identifier": "G066362",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophie Tabrizi, MA
• Mizuki Cheryl Tadokoro, D.D.S.
• Charles Allen Talley, CADC II ,A6060611
• Daniel Tin-Yuen Tam, M.D.
• Kanoko Taniguchi Tanaka, NMD
• Eveette Michelle Tavakkoly, RDH
• Ramin Tayani, M.D.
• Taylor Health Services Inc
• Lesa Taylor, FNP-C
• Natalie Taylor

• Therapeutic Radiology Physician in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Therapeutic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.