Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | G10919 | CA |
NPI | 1225269509 |
---|---|
Provider Name | Dr. Robert Michael Tager |
First Address | Sierra Madre, CA 91024-2412 |
Second Address | Sierra Madre, CA 91024-2412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 04/08/2009 |