Basic Information
| Provider Information | |||||||||
| NPI: | 1396770905 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAMMELA | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | ROSS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 625 34TH ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933012307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8336782781 | ||||||||
| FaxNumber: | 6613680618 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 S PALISADE DR STE 203 | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934548903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053547101 | ||||||||
| FaxNumber: | 8053547102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 03/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 48141 | WI | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | C153083 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 34648200 | 05 | WI | MEDICAID |