Individual
DR. JAY GERARD TASSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 CAMINO DE LOS MARES, SUITE 400, SAN CLEMENTE, CA 92673-2835
(949) 248-4547
Mailing address
1001 W 17TH ST, AUSTIN, TX 78701-1008
(512) 786-2611
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
ABR BOARD CERT. 1993
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G066362
CALIFORNIA PHYSICIAN & SURGEON'S LICENSE
CA
Enumeration date
07/10/2014
Last updated
07/10/2014
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