Individual
JENNIFER L TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
478 S ANAHEIM HILLS RD, ANAHEIM, CA 92807-4241
(714) 282-5437
(714) 282-8724
Mailing address
8078 E SANTA ANA CANYON RD, ANAHEIM, CA 92808-1108
(714) 974-2900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G66144
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659708436
—
CA
Enumeration date
10/11/2013
Last updated
11/11/2021
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