FATIMA CABAL TAGLE


Address: 3202 E Greenway Rd, Phoenix, AZ 85032-4548
Phone: 6023255577

FATIMA CABAL TAGLE (NPI# 1033201405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033201405
Entity Type Individual
Full Name FATIMA CABAL TAGLE
Other Name FATIMA CASTANAR CABAL
Credential NP
Practice Address 3202 E Greenway Rd
Phoenix
AZ 85032-4548
Mailing Address 21618 N 44th Pl
Phoenix
AZ 85050-6934
Practice Telephone 6023255577
Mailing Telephone 4805130793
Mailing Fax Number 4805130793
Enumeration Date 2006-09-29
Last Update Date 2020-04-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner 4704203126 MI Physician Assistants & Advanced Practice Nursing Providers
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
AP3316 AZ Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI 470247810 05
MI 470246910 05
MI RR MEDICARE P00231988 01
MI BLUE SHIELD FC203126 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
3003 N 3rd St, Suite 800, Phoenix, AZ 850123031 6024621132 6024621131

Office Location

Street Address 3202 E GREENWAY RD
City PHOENIX
State AZ
Zip Code 85032-4548

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1053582684 Pierce West Waychoff Chiropractor 3202 E Greenway Rd, Ste. 1619, Phoenix, AZ 85032-4548 2008-03-24
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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City PHOENIX
Zip Code 85032

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Dataset Information

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.

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