MEDICARE: DR. JOSETTE RENEE TAGLIERI 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
1	207Q00000X	Family Medicine Physician	20A5258	CA

General Provider Information

NPI Number	:	1497710842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSETTE RENEE TAGLIERI D.O.

Provider Business Mailing Address
First Line	:	18800 MAIN ST
Second Line	:	104
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-1707
Country	:	US
Telephone Number	:	714-841-1963
Fax Number	:	714-841-6919

Provider Business Practice Location Address
First Line	:	18800 MAIN ST
Second Line	:	104
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-1707
Country	:	US
Telephone Number	:	714-841-1963
Fax Number	:	714-841-6919

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	09/02/2010

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