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NPI Code Detail

MEDICARE: DR. EMMANUEL V TAGUBA M.D.

MEDICARE: DR. EMMANUEL V TAGUBA 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
1208000000XPediatrics Physician6669NV

General Provider Information

NPI Number : 1871540492
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMMANUEL V TAGUBA M.D.
Provider Business Mailing Address
First Line : 2031 MCDANIEL ST
Second Line : SUITE 220
City : NORTH LAS VEGAS
State : NV
Zip : 89030-6303
Country : US
Telephone Number : 702-642-1409
Fax Number : 702-642-3675
Provider Business Practice Location Address
First Line : 2031 MCDANIEL ST
Second Line : SUITE 220
City : NORTH LAS VEGAS
State : NV
Zip : 89030-6303
Country : US
Telephone Number : 702-642-1409
Fax Number : 702-642-3675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 07/09/2007

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