Provider Demographics
NPI:1649652041
Name:TAMON, OSCAR
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:TAMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 NEW HAMPSHIRE AVE APT 603
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-2827
Mailing Address - Country:US
Mailing Address - Phone:240-472-5364
Mailing Address - Fax:
Practice Address - Street 1:6735 NEW HAMPSHIRE AVE APT 603
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-2827
Practice Address - Country:US
Practice Address - Phone:240-472-5364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11327374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT-550-667-625-035OtherDRIVERS LICENSE