Provider Demographics
NPI:1952391450
Name:TARRAN, WILLIAM A (DPM)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:TARRAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:901 CAMPUS DR
Mailing Address - Street 2:STE 311
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4900
Mailing Address - Country:US
Mailing Address - Phone:650-757-3338
Mailing Address - Fax:650-756-7769
Practice Address - Street 1:1216 SEVILLE DR
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-3554
Practice Address - Country:US
Practice Address - Phone:650-245-5745
Practice Address - Fax:650-738-2455
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE36230213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA480026769OtherRAILROAD MEDICARE
CA000E36230Medicaid
CA480026769OtherRAILROAD MEDICARE
T90350Medicare UPIN