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NPI Code Detail

MEDICARE: MINERVA A TAVAREZ

MEDICARE:   MINERVA A TAVAREZ
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
1171M00000XCase Manager/Care Coordinator

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ92069ZOTHERCASANTA CRUZ COUNTY MEDICARE GROUP PTAN#

General Provider Information

NPI Number : 1740406479
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINERVA A TAVAREZ
Provider Business Mailing Address
First Line : 709 MISSION ST
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-3614
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 380 ENCINAL ST STE 200
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-2178
Country : US
Telephone Number : 831-469-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 05/23/2023

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Directions to “ MINERVA A TAVAREZ ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.