Individual
ANNE E TAIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5150 HILL RD E STE C, LAKEPORT, CA 95453-5100
(707) 263-3520
(707) 263-3570
Mailing address
5150 HILL RD E STE C, LAKEPORT, CA 95453-5100
(707) 263-3520
(707) 263-3570
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0G62640
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ28485Z
BLUE SHIELD
CA
Enumeration date
11/15/2005
Last updated
07/19/2007
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