MR. GETHSEMANE VAE TAGALOA (NPI# 1760653794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760653794 |
| Entity Type | Individual |
| Full Name | MR. GETHSEMANE VAE TAGALOA |
| Practice Address |
20715 Avalon Blvd Suite #200 Carson CA 90746-3317 |
| Mailing Address |
20715 S. Avalon Blvd. Suite #200 Carson CA 90746 |
| Practice Telephone | 3107560180 |
| Practice Fax Number | 3103297914 |
| Mailing Telephone | 3107560180 |
| Mailing Fax Number | 3103297914 |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2012-11-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
20715 AVALON BLVD SUITE #200 |
| City | CARSON |
| State | CA |
| Zip Code | 90746-3317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172837 | Darren Nakano Chiropractic, Professional Corporation | Chiropractor | 460 East Carson Plaza Drive, Suite 116, Carson, CA 90746 | 2019-09-05 |
| 1205370079 | Natalie Bland | Nurse Practitioner | 454 E. Carson Plaza Drive Suite 211, Carson, CA 90746 | 2016-12-13 |
| 1891146767 | Francis O Okpan | Nurse Practitioner | 17546 Buttonwood Ln, Carson, CA 90746 | 2016-06-22 |
| 1689049371 | Fresenius Medical Care Long Beach, LLC | Clinic/Center | 20710 Leapwood Ave Ste E, Carson, CA 90746 | 2015-12-07 |
| 1447649108 | Brandi Glenn | Occupational Therapist | 17811 Hazelwood Court, Carson, CA 90746 | 2015-01-20 |
| 1700226263 | Allen Berger | Counselor | 460 Est. Carson Plaza Dr. #119, Carson, CA 90746 | 2013-06-28 |
| 1902147036 | Basen Inc | Counselor | 460 Carson Plaza Drive, Ste 106, Carson, CA 90746 | 2013-03-14 |
| 1811238298 | Basen Inc | Counselor | 460 E Carsin Plaza Dr, #106, Carson, CA 90746 | 2013-03-08 |
| 1871858084 | Joseph H. Rodd M.d. Inc | Psychiatry & Neurology | 20710 S. Leapwood Ave., Suite B, Carson, CA 90746 | 2012-07-13 |
| 1467718601 | Laquesha Shonte Robinson | Counselor | 460 E. Carson Plaza Drive, Suite 200, Carson, CA 90746 | 2012-04-02 |
| Find all providers in zip 90746 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588008262 | Tamara Tavai | Rehabilitation Practitioner | 603 W 231st St, Carson, CA 90745-4617 | 2013-04-24 |
| 1275813073 | Edith Mercado-jimenez | Rehabilitation Practitioner | 649 E Albertoni St Ste 100, Carson, CA 90746-1538 | 2011-08-24 |
| 1609013556 | Tracey Josefa Nolen | Rehabilitation Practitioner | 649 E Albertoni St, Suite 100, Carson, CA 90746-1538 | 2009-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092447 | Isaiah Daniel Clark | Rehabilitation Practitioner | 33600 Mapleton Ave # D2018, Murrieta, CA 92563-4434 | 2020-10-31 |
| 1760089122 | Leslie Ann Showalter | Rehabilitation Practitioner | 6720 Tampa Ave, Reseda, CA 91335-5014 | 2020-10-07 |
| 1508477019 | Brenda Cabrera | Rehabilitation Practitioner | 127 W Hillcrest Blvd, Inglewood, CA 90301-2623 | 2020-08-10 |
| 1669082202 | Brenda Vargas | Rehabilitation Practitioner | 16650 Sherman Way # 201, Van Nuys, CA 91406-3782 | 2020-08-07 |
| 1629696042 | Ashlie Renee Javier | Rehabilitation Practitioner | 1266 Calle Estrella, San Dimas, CA 91773-4080 | 2020-07-13 |
| 1861013757 | Terrisa Noel-rivera Luna | Rehabilitation Practitioner | 11303 Wilshire Blvd Bld 116, Los Angeles, CA 90025-5069 | 2020-05-01 |
| 1780212852 | Isaiah Sanchez | Rehabilitation Practitioner | 10535 Zelzah Ave, Granada Hills, CA 91344-5902 | 2020-04-01 |
| 1235766015 | Theresa Matheson | Rehabilitation Practitioner | 15533 Ryon Ave, Bellflower, CA 90706-3624 | 2020-03-24 |
| 1669008991 | Delman Lee Williams | Rehabilitation Practitioner | 456 E Orange Grove Blvd Ste 140, Pasadena, CA 91104-5235 | 2020-03-18 |
| 1356976864 | Millea Jewel Betts | Rehabilitation Practitioner | 801 E Chapman Ave # Sut203, Fullerton, CA 92831-3839 | 2020-03-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.