Provider Demographics
NPI:1457474033
Name:ARENE, TAGBO EKENE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:TAGBO
Middle Name:EKENE
Last Name:ARENE
Suffix:
Gender:M
Credentials:MD, MPH
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Other - Credentials:
Mailing Address - Street 1:303 E. VANDERBILT WAY
Mailing Address - Street 2:COUNTY OF SAN BERNARDINO, DBH
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415
Mailing Address - Country:US
Mailing Address - Phone:909-388-0810
Mailing Address - Fax:909-890-0281
Practice Address - Street 1:303 E VANDERBILT WAY COUNTY OF SAN BERNARDINO DBH
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-2804
Practice Address - Country:US
Practice Address - Phone:909-388-0810
Practice Address - Fax:909-890-0281
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1393962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA139396OtherMEDICAL BOARD OF CALIFORNIA (PHYSICIAN & SURGEON A LICENSE)