Active NPI
Edward Tagge, MD
- Pediatric Surgery Physician
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- G88002
- Practice address
- 11370 Anderson St
Suite 2100
Loma Linda, CA 92354-3450 - Phone
- (909) 558-2282
- Fax
- (909) 558-2125
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | G88002 | CA | Primary |
| Surgery Physician | 208600000X | G88002 | CA | |
| Surgical Critical Care Physician | 2086S0102X | G88002 | CA | |
| Pediatric Surgery Physician | 2086S0120X | 15516 | SC |
Addresses
Primary practice location
11370 Anderson St
Suite 2100
Loma Linda, CA 92354-3450
Mailing address
11175 Campus St
CP-21111
Loma Linda, CA 92354
Phone (909) 558-4619
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 155165 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G88002 | CA | MD | Surgical Critical Care Physician |
| 15516 | SC | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Surgery | Current | Accepting new patients |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Loma Linda University Children'S Hospital | Past | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Surgery | Past | Accepting new patients |
| Loma Linda University Medical Center | Past | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Surgery | Past | Accepting new patients |
| Riverside Healthcare System, L.P. | Past | Accepting new patients |
Locations
11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154
11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2824
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617
11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700
Interoperability endpoints
- etagge11535@direct.llu.edu
Organizations & group practices 11
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Apple Valley, CA
- NPI 1205009917
-
- Pediatrics Physician
- Moreno Valley, CA
- NPI 1073563748
-
- Neurology Physician
- Loma Linda, CA
- NPI 1386694313
-
- Ophthalmology Physician
- Loma Linda, CA
- NPI 1437109469
-
- Anatomic Pathology Physician
- Murrieta, CA
- NPI 1588020432
-
- Pediatrics Physician
- Highland, CA
- NPI 1689624991
-
- Orthopaedic Surgery Physician
- Loma Linda, CA
- NPI 1275582918
-
- Surgery Physician
- Moreno Valley, CA
- NPI 1518917772
-
- Children's Hospital
- Loma Linda, CA
- NPI 1366866345
-
- General Acute Care Hospital
- Loma Linda, CA
- NPI 1194731935
-
- Rehabilitation Hospital Unit
- Riverside, CA
- NPI 1053358010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768435200000",
"number": "1255446100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11175 CAMPUS ST",
"address_2": "CP-21111",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92354",
"telephone_number": "909-558-4619",
"fax_number": "909-558-7978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11370 ANDERSON ST",
"address_2": "SUITE 2100",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543450",
"telephone_number": "909-558-2282",
"fax_number": "909-558-2125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAGGE",
"first_name": "EDWARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2026-01-15",
"certification_date": "2026-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "CA",
"license": "G88002",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G88002",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "CA",
"license": "G88002",
"primary": false
},
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "SC",
"license": "15516",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "155165",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.