MR. GETHSEMANE VAE TAGALOA NPI 1760653794

NPI Information

NPI: 1760653794
Provider Name: MR. GETHSEMANE VAE TAGALOA
Classification: Rehabilitation Practitioner - 225400000X
Entity Type: Individual
Address:
20715 AVALON BLVD
SUITE #200
CARSON, CA
ZIP 90746
Phone: (310) 756-0180
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MR. Gethsemane Vae Tagaloa is a rehabilitation practitioner in Carson, CA. The provider is a health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. MR. Gethsemane Vae Tagaloa NPI is 1760653794. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

20715 AVALON BLVD
SUITE #200
CARSON, CA
ZIP 90746-317
Phone: (310) 756-0180
Fax: (310) 329-7914

The enumeration date for this NPI number is 3/18/2008 and was last updated on 11/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225400000X	Rehabilitation Practitioner				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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