Basic Information
| Provider Information | |||||||||
| NPI: | 1609196187 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TINLOY | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 MERCED ST | ||||||||
| Address2: | |||||||||
| City: | SAN LEANDRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945774201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104544010 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2500 MERCED ST | ||||||||
| Address2: | |||||||||
| City: | SAN LEANDRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945774201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104544010 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2010 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 52144 | CT | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 20A13861 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.