Provider Demographics
NPI:1053818286
Name:TARASH, IGAL (DO MD EMBA)
Entity type:Individual
Prefix:
First Name:IGAL
Middle Name:
Last Name:TARASH
Suffix:
Gender:M
Credentials:DO MD EMBA
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Other - Credentials:
Mailing Address - Street 1:1966 TICE VALLEY BLVD # 112
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-2203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11937 US HIGHWAY 271
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75708-3154
Practice Address - Country:US
Practice Address - Phone:903-877-7168
Practice Address - Fax:903-877-8356
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS65382084P0800X
CA195232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry