Individual
CARLOS R TAVARES SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
165 W HOSPITALITY LN STE 11, SAN BERNARDINO, CA 92408-3322
(909) 300-2622
(909) 300-2622
Mailing address
165 W HOSPITALITY LN STE 11, SAN BERNARDINO, CA 92408-3322
(909) 300-2622
(909) 300-2622
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
Other
Enumeration date
04/16/2026
Last updated
04/16/2026
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