Provider Demographics
NPI:1083749204
Name:TAGORE, TARLOCHAN SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:TARLOCHAN
Middle Name:SINGH
Last Name:TAGORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 JENSEN AVE
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657
Mailing Address - Country:US
Mailing Address - Phone:559-875-5521
Mailing Address - Fax:559-875-2032
Practice Address - Street 1:1822 JENSEN AVE
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657
Practice Address - Country:US
Practice Address - Phone:559-875-5521
Practice Address - Fax:559-875-2032
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A314000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A314000Medicaid
CAA26463Medicare ID - Type Unspecified
CA00A314000Medicaid