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NPI Code Detail

MEDICARE: JAMES P. TASTO M.D.

MEDICARE: JAMES P. TASTO M.D.
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
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianG14672CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2WG14672DOTHERCAMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124021936
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES P. TASTO M.D.
Provider Business Mailing Address
First Line : 6719 ALVARADO RD
Second Line : STE 200
City : SAN DIEGO
State : CA
Zip : 92120-5256
Country : US
Telephone Number : 619-229-3932
Fax Number : 619-582-2860
Provider Business Practice Location Address
First Line : 6719 ALVARADO RD
Second Line : STE 200
City : SAN DIEGO
State : CA
Zip : 92120-5256
Country : US
Telephone Number : 619-229-3932
Fax Number : 619-582-2860
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 09/15/2017

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