Individual
MICHAEL A TANNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 S PACIFIC AVE, SAN PEDRO, CA 90731-2656
(310) 519-8723
Mailing address
2245 VIA CERRITOS, PALOS VERDES ESTATES, CA 90274-2141
(310) 955-6914
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-OSGVLK
CA
Other
Enumeration date
04/01/2025
Last updated
04/01/2025
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