Provider Demographics
NPI:1891508826
Name:TAMKIN, NESAR AHMAD SR
Entity type:Individual
Prefix:MR
First Name:NESAR
Middle Name:AHMAD
Last Name:TAMKIN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6665 KOSTER WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-4939
Mailing Address - Country:US
Mailing Address - Phone:916-890-9630
Mailing Address - Fax:
Practice Address - Street 1:6665 KOSTER WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-4939
Practice Address - Country:US
Practice Address - Phone:916-890-9630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1234171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty