=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023342540
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMAL TANAGHO PSYCHIATRIC SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2009
-----------------------------------------------------
Last Update Date | 07/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18672 FLORIDA ST STE 201C
-----------------------------------------------------
City | HUNTINGTON BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92648-6088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-916-0499
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18672 FLORIDA ST STE 201C
-----------------------------------------------------
City | HUNTINGTON BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92648-6088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-916-0499
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIST
-----------------------------------------------------
Name | AMAL B TANAGHO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-916-0499
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------