Provider Demographics
NPI:1871566406
Name:TEKIN, NECATI UYGUR (MD)
Entity type:Individual
Prefix:
First Name:NECATI
Middle Name:UYGUR
Last Name:TEKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:N.
Other - Middle Name:UYGUR
Other - Last Name:TEKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1004 FOWLER WAY
Mailing Address - Street 2:SUITE NO: 4
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667
Mailing Address - Country:US
Mailing Address - Phone:530-626-9488
Mailing Address - Fax:530-626-1104
Practice Address - Street 1:1004 FOWLER WAY
Practice Address - Street 2:SUITE NO: 4
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667
Practice Address - Country:US
Practice Address - Phone:530-626-9488
Practice Address - Fax:530-626-1104
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52029207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC52029Medicaid
CAC52029OtherMEDICARE ID-TYPE UNSPECIFIED
CAC52029OtherBLUE SHIELD OF CALIFORNIA
CAC52029OtherMEDICARE ID-TYPE UNSPECIFIED