Provider Demographics
NPI:1790704302
Name:ABORDO, MARIA TAGLE (MD)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:TAGLE
Last Name:ABORDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:TAGLE
Other - Last Name:ABORDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1878 TUSCANY DR
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-8335
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5730 PACKARD AVE
Practice Address - Street 2:STE 600
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-7118
Practice Address - Country:US
Practice Address - Phone:530-741-6245
Practice Address - Fax:530-741-9274
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60310208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA603100Medicaid