Individual
MR. RALPH EMMANUEL TAGUBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2074 S 6TH ST, KLAMATH FALLS, OR 97601-3372
(541) 851-8110
Mailing address
2074 S 6TH ST, KLAMATH FALLS, OR 97601-3372
(541) 851-8110
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
1158708
NV
363A00000X
Physician Assistant
PA191687
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170061
—
OR
Enumeration date
12/04/2018
Last updated
12/10/2019
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