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General NPI Number Information
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NPI Number | 1124251632
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Entity Type | Organization
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Legal Business Name | PRECISE HEALTH
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 165 W HOSPITALITY LN STE 101
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3334
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Country | US
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Telephone | 909-379-9368
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Fax |
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Provider Business Mailing Address
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Address Line | 165 W HOSPITALITY LN STE 101
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3334
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Country | US
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Telephone | 909-379-9368
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | STEVE TRAGOON
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Credential | M.D.
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Telephone | 909-379-9368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A35998
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License Number State | CA
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