Individual
DOROTHY A TAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CPNP
Contact information
Practice address
30210 RANCHO VIEJO RD, SUITE A, SAN JUAN CAPISTRANO, CA 92675-1574
(949) 493-7337
(949) 493-1418
Mailing address
30210 RANCHO VIEJO RD, SUITE A, SAN JUAN CAPISTRANO, CA 92675-1574
(949) 493-7337
(949) 493-1418
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
304991
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
20274
CA
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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