Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 24017 | CA |
NPI | 1740407899 |
---|---|
Provider Name | Mrs. Tanya L Langis |
First Address | Oceanside, CA 92056-4405 |
Second Address | Vista, CA 92081-6056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CP8020 | MEDICARE RAILROAD (01) | CA |