Provider Demographics
NPI:1144482621
Name:STREET, TYLER C (MD)
Entity type:Individual
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First Name:TYLER
Middle Name:C
Last Name:STREET
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3443 VILLA LN STE 10
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6417
Mailing Address - Country:US
Mailing Address - Phone:707-927-3508
Mailing Address - Fax:707-266-1627
Practice Address - Street 1:3443 VILLA LN STE 10
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6417
Practice Address - Country:US
Practice Address - Phone:707-927-3508
Practice Address - Fax:707-266-1627
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2022-10-20
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Provider Licenses
StateLicense IDTaxonomies
CA138470208200000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery