Individual
DR. WILLIAM S. TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2125 OAK GROVE RD STE 200, WALNUT CREEK, CA 94598-2520
(925) 296-7150
Mailing address
2152 CLINTON AVE, APT C, ALAMEDA, CA 94501-6618
(510) 457-1899
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
A63125
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A631250
BLUE SHIELD
CA
05
—
00A631250
—
CA
01
—
P00360941
RAIL ROAD MEDICARE
—
Enumeration date
07/07/2006
Last updated
12/20/2021
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