Individual
JASON VAN TASSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2557 MOWRY AVE STE 30, FREMONT, CA 94538-1614
(510) 248-1590
Mailing address
2557 MOWRY AVE STE 30, FREMONT, CA 94538-1614
(510) 248-1590
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A79305
CA
Other
Enumeration date
08/20/2006
Last updated
09/18/2013
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