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NPI Code Detail

MEDICARE: MR. JESUS ARTURO TAPIA RETAMOZA

MEDICARE: MR. JESUS ARTURO TAPIA RETAMOZA
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
1372600000XAdult Companion
2171M00000XCase Manager/Care Coordinator
3174H00000XHealth Educator
4225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1639003163
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JESUS ARTURO TAPIA RETAMOZA
Provider Business Mailing Address
First Line : 10400 FRICOT CITY RD UNIT J
Second Line :
City : SAN ANDREAS
State : CA
Zip : 95249-9642
Country : US
Telephone Number : 239-736-2689
Fax Number :
Provider Business Practice Location Address
First Line : 10400 FRICOT CITY RD UNIT J
Second Line :
City : SAN ANDREAS
State : CA
Zip : 95249-9642
Country : US
Telephone Number : 239-736-2689
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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