Eugene Tachuk, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A036884 Issued in CA

Practice address

3740 Rosecrans St Ste C
San Diego, CA 92110-3126

Phone

(619) 222-5433

NPI assigned

Jul 8, 2015

Last updated

Jul 8, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medixpartners.Com, a Professional Medical Corporation

  dba Viva Wellness Medical Group

  • Primary Care Clinic/Center
  • San Diego, CA
  • NPI 1023317799
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1417330432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 ROSECRANS ST STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103126",
            "telephone_number": "619-222-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 ROSECRANS ST STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103126",
            "telephone_number": "619-222-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACHUK",
        "first_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A036884",
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "CA",
            "license": "A036884",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A036884",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A036884",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "A036884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Tabron
• Sarah Tabsh
• Alyssa Tabula, RN
• Desiree Tachiki Lopez
• Iliana Tachin-Rodriguez
• Edward Aaron Tackett
• Freddie Tackett
• Ismael D Tactay Jr., RRT
• Stephanie Marie Tactay, MSN, RN, PMH-BC
• Tactical Rehabilitation, Inc.

• General Practice Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.