Provider Demographics
NPI:1144249574
Name:LUND, TAMARA FRANCES (DC, DACNB)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:FRANCES
Last Name:LUND
Suffix:
Gender:F
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 S FOREST RD
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-4802
Mailing Address - Country:US
Mailing Address - Phone:209-536-9182
Mailing Address - Fax:209-536-9124
Practice Address - Street 1:6 S FOREST RD
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-4802
Practice Address - Country:US
Practice Address - Phone:209-536-9182
Practice Address - Fax:209-536-9124
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 25747111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25747Medicare UPIN
CADC0257470Medicare ID - Type UnspecifiedMEDICARE ID