Individual
TARA REID
Active
Individual
TARA REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
20A6919
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX69190
—
CA
01
—
1972792729
MEDICARE GROUP NPI
CA
01
—
1982627956
MEDICARE INDIVIDUAL NPI
CA
05
—
GR0105170
—
CA
Enumeration date
07/25/2006
Last updated
01/29/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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