Organization
VIPIN M. TANDON M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY LEAH LACKIE (OFFICE MANAGER)
(805) 522-3195
Entity
Organization
Contact information
Practice address
1687 ERRINGER RD, SUITE 103, SIMI VALLEY, CA 93065-6508
(805) 522-3195
Mailing address
1687 ERRINGER RD, SUITE 103, SIMI VALLEY, CA 93065-6508
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A26262
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A262620
—
CA
Enumeration date
05/01/2007
Last updated
10/02/2017
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