Provider Demographics
NPI:1407851041
Name:SACAMAY, TAGUMPAY E (MD)
Entity Type:Individual
Prefix:DR
First Name:TAGUMPAY
Middle Name:E
Last Name:SACAMAY
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 1:4225 EXECUTIVE SQ STE 450
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8411
Mailing Address - Country:US
Mailing Address - Phone:858-810-0000
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:655 EUCLID AVE
Practice Address - Street 2:STE 303
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2957
Practice Address - Country:US
Practice Address - Phone:619-475-4900
Practice Address - Fax:619-475-8373
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62631207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A626310Medicaid
CAG51444Medicare UPIN
CAWA62631AMedicare PIN