Tracie B. Tavel, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G51833 Issued in CA

Practice address

39400 Paseo Padre Pkwy
Fremont, CA 94538-2310

Phone

(510) 795-3000

NPI assigned

Oct 25, 2006

Sex

Female

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851476527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39400 PASEO PADRE PKWY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382310",
            "telephone_number": "510-795-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVEL",
        "first_name": "TRACIE",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G51833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G518330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shahina Tariq
• Thomas Willard Tarkington Jr.
• Sadaf Tarzi
• Lea Kristen Tate, PSY.D.
• Louisa Taufaasau
• David Tay, M.D.
• Mohammad Tayarani Beegham
• Claribel Paguio Taylor, M.D.
• Daniel Taylor, M.D.
• Rachelle Catherine Taylor

• Dermatology Physician in Fremont, CA
• Providers in Fremont, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.