Provider Demographics
NPI:1962519652
Name:TSUCHIYA, PAMELA Y (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:Y
Last Name:TSUCHIYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 W GRANT LINE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-7330
Mailing Address - Country:US
Mailing Address - Phone:209-835-2227
Mailing Address - Fax:209-835-2250
Practice Address - Street 1:2160 W GRANT LINE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-7330
Practice Address - Country:US
Practice Address - Phone:209-835-2227
Practice Address - Fax:209-835-2250
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74382207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G743820Medicaid
CA00G743820Medicaid
CA00G743820Medicare PIN