Individual
AMANDA TAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A60188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A601880
MEDI CAL
CA
05
—
00A601880
—
CA
01
—
P01288574/ DS9933
RAILROAD MEDICARE- 55TH ST
CA
01
—
P01453275-DV5277
RAILROAD MEDICARE
CA
Enumeration date
08/01/2006
Last updated
03/30/2018
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