Tara Rithaporn Agena, M.D. Valid NPI
Individual provider · Pediatrics Physician · San Bernardino, CA
- NPI
- 1629249859
- Type
- Individual (Type 1)
- Primary specialty
- Pediatrics Physician (Pediatrics)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 208000000X
- License number
- A97352 (CA)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2008-03-15
- Last updated
- 2021-11-29
Practice location
565 N Mount Vernon Ave
San Bernardino, CA 92411-2661
(909) 884-9091