Individual
SHAWN TAHATA
Active
Individual
SHAWN TAHATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29219
MN
207R00000X
Internal Medicine Physician
66118
MN
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
174662A
CA
Other
Enumeration date
03/24/2018
Last updated
09/16/2023
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