Provider Demographics
NPI:1700867868
Name:TACLIAD JR, FRANCISCO BAGALAYOS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:BAGALAYOS
Last Name:TACLIAD JR
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:NAVAL HOSPITAL
Mailing Address - Street 2:BLDG 100
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055-5191
Mailing Address - Country:US
Mailing Address - Phone:760-725-0733
Mailing Address - Fax:760-725-1101
Practice Address - Street 1:NAVAL HOSPITAL CAMP PENDLETON
Practice Address - Street 2:BUILDING H-100
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-5191
Practice Address - Country:US
Practice Address - Phone:760-725-0733
Practice Address - Fax:760-725-1101
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CA15785363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant