Individual
ANGELA L TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5601 W CHINDEN BLVD, GARDEN CITY, ID 83714-1463
(208) 809-2865
(208) 809-2866
Mailing address
PO BOX 191050, SUITE 250, BOISE, ID 83719-1050
(208) 955-6500
(208) 955-6501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0-0370
ID
207Q00000X
Family Medicine Physician
Primary
O-0370
ID
207Q00000X
Family Medicine Physician
Primary
O0370
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807273000
—
ID
Enumeration date
06/11/2006
Last updated
02/19/2026
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