Individual
THERESA ANN TACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Mailing address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C50143
CA
2080P0202X
Pediatric Cardiology Physician
Primary
C50143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C501430
—
CA
Enumeration date
06/25/2006
Last updated
04/11/2024
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