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NPI Code Detail

MEDICARE: BERTHA F TSAI-TULAGAN D.O.

MEDICARE:   BERTHA F TSAI-TULAGAN  D.O.
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
12080A0000XPediatric Adolescent Medicine Physician34.008124OH
2208000000XPediatrics Physician20A9673CA

General Provider Information

NPI Number : 1417914268
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERTHA F TSAI-TULAGAN D.O.
Provider Business Mailing Address
First Line : 6942 UNIVERSITY AVE STE A
Second Line :
City : LA MESA
State : CA
Zip : 91942-5963
Country : US
Telephone Number : 619-698-2184
Fax Number :
Provider Business Practice Location Address
First Line : 6942 UNIVERSITY AVE STE A
Second Line :
City : LA MESA
State : CA
Zip : 91942
Country : US
Telephone Number : 619-698-2184
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 11/26/2018

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Directions to “ BERTHA F TSAI-TULAGAN D.O.” Practice Location

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