Individual
FREDERICK LAMOND TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN MS
Contact information
Practice address
2275 ARLINGTON DRIVE, SAN LEANDRO, CA 94578
(510) 317-1444
Mailing address
2275 ARLINGTON DRIVE, SAN LEANDRO, CA 94578
(510) 317-1444
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
INTERIM PERMIT 1
CA
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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