Mrs. Tara Rithaporn Agena
M.D. | Pediatrics | Female
Mrs. Tara Rithaporn Agena, M.D. is a San Bernardino, California based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Mrs. Tara Rithaporn Agena is
565 N Mount Vernon Ave, San Bernardino, California - 92411-2661. She can be contacted on phone at
909-884-9091 and fax number 909-383-7013.
Mrs. Tara Rithaporn Agena is a sole proprietor of her business.
NPI number (Unique professional ID) for Mrs. Tara Rithaporn Agena is
1629249859 which was assigned by NPPES on 15 Mar, 2008 and it was last updated on 29 Nov, 2021.
Mrs. Tara Rithaporn Agena license number is
A97352 for Pediatrics (208000000X) in California.
Mrs. Tara Rithaporn Agena is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Mrs. Tara Rithaporn Agena basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Mrs. Tara Rithaporn Agena |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Mrs. Tara Rithaporn Agena address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 565 N Mount Vernon Ave
San Bernardino, CA, 92411-2661
United States |
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| Phone Number : | 909-884-9091 |
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| Fax Number : | 909-383-7013 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1629249859 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 15 Mar, 2008 |
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| Last Updated On : | 29 Nov, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mrs. Tara Rithaporn Agena are as mentioned. Primary taxonomy code for Mrs. Tara Rithaporn Agena, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | A97352 | CA |
Legacy Identifiers:
Other legacy medical identifiers of Mrs. Tara Rithaporn Agena such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 00A973520 | MEDICAID | CA | |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
SOAP
(SOAP URL) | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Carequality | | HIE
Health Information Exchange (HIE)
| OTHER
Other
C-CDA | 9961 SIERRA AVE,
FONTANA, CA, 92335-6720
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 685 Carnegie Dr, Suite 230
San Bernardino, CA, 92408-3502
United States |
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| Phone Number : | 909-890-0407 |
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| Fax Number : | 909-890-4597 |
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Business Location:
Patients can refer following map for directions to
Mrs. Tara Rithaporn Agena practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.