Individual
MR. CODY JAY TAPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
555 E TACHEVAH DR, SUITE 2W-203, PALM SPRINGS, CA 92262-5750
(760) 323-4272
(760) 323-8597
Mailing address
555 E TACHEVAH DR, SUITE 2W-203, PALM SPRINGS, CA 92262-5750
(760) 323-4272
(760) 323-8597
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
52166
CA
363AM0700X
Medical Physician Assistant
11496780-1206
UT
363AS0400X
Surgical Physician Assistant
11496780-1206
UT
Other
Enumeration date
12/01/2014
Last updated
12/12/2023
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