Provider Demographics
NPI:1740812866
Name:MCGINNIS, TAUNA
Entity type:Individual
Prefix:
First Name:TAUNA
Middle Name:
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 SOQUEL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1715
Mailing Address - Country:US
Mailing Address - Phone:831-475-9255
Mailing Address - Fax:831-475-9261
Practice Address - Street 1:1570 SOQUEL DR STE 4
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1715
Practice Address - Country:US
Practice Address - Phone:831-475-9255
Practice Address - Fax:831-475-9261
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health