Individual
EDWARD TAGGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11370 ANDERSON ST, SUITE 2100, LOMA LINDA, CA 92354-3450
(909) 558-2282
(909) 558-2125
Mailing address
11175 CAMPUS ST, CP-21111, LOMA LINDA, CA 92354
(909) 558-4619
(909) 558-7978
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G88002
CA
2086S0102X
Surgical Critical Care Physician
G88002
CA
2086S0120X
Pediatric Surgery Physician
15516
SC
2086S0120X
Pediatric Surgery Physician
Primary
G88002
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155165
—
SC
Enumeration date
08/20/2006
Last updated
01/15/2026
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