Provider Demographics
NPI:1033432273
Name:MARK JUDE TRAMO MD APC
Entity type:Organization
Organization Name:MARK JUDE TRAMO MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRAMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-495-6702
Mailing Address - Street 1:2220 LYNN RD STE 303
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8003
Mailing Address - Country:US
Mailing Address - Phone:805-495-6702
Mailing Address - Fax:805-495-6195
Practice Address - Street 1:555 MARIN ST STE 200
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4105
Practice Address - Country:US
Practice Address - Phone:805-495-6702
Practice Address - Fax:805-495-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG88591Medicaid