Provider Demographics
NPI:1427169366
Name:TARIN MEDICAL CORPORATION
Entity type:Organization
Organization Name:TARIN MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:VILAIVAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:TARIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-734-5450
Mailing Address - Street 1:900 S MAIN ST STE 108
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3401
Mailing Address - Country:US
Mailing Address - Phone:951-734-5450
Mailing Address - Fax:951-734-6009
Practice Address - Street 1:900 S MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3401
Practice Address - Country:US
Practice Address - Phone:951-734-5450
Practice Address - Fax:951-734-6009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TARIN MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0046400OtherMEDI-CAL
CACD320AOtherMEDICARE PTAN
CAA31855OtherMEDICARE PTAN
CAA26622Medicare UPIN
CAA31855Medicare PIN