Dr. Tanner Candelore, D.O.
Physical Medicine & Rehabilitation in San Diego, CA. Individual provider (NPI-1).
NPI number1508304429
StatusActive
Last updated in NPPESJul 19, 2021
Details
- NPI
- 1508304429
- Entity type
- Individual (NPI-1)
- Name
- Dr. Tanner Candelore
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 11, 2017
- Certification date
- Jul 19, 2021
- Last updated
- Jul 19, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 18655 | CA | Yes |
Practice location
3350 La Jolla Village DrSan Diego, CA 92161-4701
Phone 858-552-8585
Mailing address
3350 La Jolla Village DrSan Diego, CA 92161-0002
Phone 858-552-8585
Other practice locations
7031 Sw 62nd Ave
South Miami, FL 33143-4701
South Miami, FL 33143-4701
Phone 305-284-7500
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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