Most Relevant Information
Provider Data
| NPI Number: | 1003037409 |
| Provider Name: | TARA VACCARO |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/01/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1124 BAY BLVD STE D
CHULA VISTA
CA
919117155
Practice Location Phone/Fax
| Phone: | 6194203620 |
| Fax: |
Provider Mailing Location
32 DORAN CT
CHULA VISTA
CA
919101912
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |