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Individual
MANUEL TATUM
Active
Individual
MANUEL TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DRIVER LICENSE
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B7208559
CA
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
6058046735
CA
Other
Enumeration date
12/19/2023
Last updated
12/29/2023
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