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General NPI Number Information
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NPI Number | 1275355976
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Entity Type | Organization
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Legal Business Name | TARANTINO MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 120 LA CASA VIA STE 106
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City | WALNUT CREEK
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State | CA
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Zip | 94598-3092
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Country | US
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Telephone | 925-448-2610
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Fax | 925-319-6253
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Provider Business Mailing Address
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Address Line | 3308 VALLEY VISTA RD
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City | WALNUT CREEK
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State | CA
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Zip | 94598-3944
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Country | US
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Telephone | 925-272-8084
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Fax | 925-448-2611
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Authorized Official
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Title or Position | OWNER
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Name | DR. TARA LAUREN TARANTINO
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Credential | DO
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Telephone | 925-448-2610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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