Individual
DR. SCOTT A TAGA, MD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1783 EL CAMINO REAL, MILLS-PENINSULA PATHOLOGY DEPT, BURLINGAME, CA 94010-3205
(650) 853-4739
Mailing address
393 E GRAND AVE, SU I, SOUTH SAN FRANCISCO, CA 94080-6233
(650) 616-2955
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
G79036
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G79036
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G790361
—
CA
01
—
G79036
MEDICAL LICENSE
CA
Enumeration date
10/25/2006
Last updated
07/13/2009
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