MEDICARE: MICHELLE TAGANI PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		NJ
2	363A00000X	Physician Assistant	PA52741	CA

General Provider Information

NPI Number	:	1366819757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE TAGANI PA

Provider Business Mailing Address
First Line	:	915 CARLETON RD
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-1689
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2659 STATE ST STE 100
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1627
Country	:	US
Telephone Number	:	866-938-3831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2015
Last Update Date	:	06/30/2025

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Directions to “ MICHELLE TAGANI PA” Practice Location

Language	Start Address	Practice Location

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